Individual
GRACELYNN K FJELSTAD
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
933 S SUNSET AVE STE 205, WEST COVINA, CA 91790-3410
(310) 553-2695
Mailing address
2236 KODIAK DR, NORTH MANKATO, MN 56003-1562
Taxonomy
Speciality
Code
Description
License number
State
225XP0200X
Pediatric Occupational Therapist
—
CA
2355S0801X
Speech-Language Assistant
Primary
—
CA
Other
Enumeration date
04/29/2024
Last updated
04/29/2024
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