Individual
ENAMULHAQ MIRZAY
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
COTA
Contact information
Practice address
1319 N MADISON ST, STOCKTON, CA 95202-1001
(209) 466-4341
Mailing address
8575 ELK GROVE FLORIN RD APT 310, ELK GROVE, CA 95624-9543
Taxonomy
Speciality
Code
Description
License number
State
224Z00000X
Occupational Therapy Assistant
Primary
—
CA
Other
Enumeration date
10/14/2021
Last updated
10/14/2021
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