Individual
MRS. EDEN R NULLAR
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
COTA
Contact information
Practice address
9609 PROSPECT AVE, LAKESIDE, CA 92040-4111
(619) 840-8859
Mailing address
9609 PROSPECT AVE, LAKESIDE, CA 92040-4111
(619) 840-8859
Taxonomy
Speciality
Code
Description
License number
State
224Z00000X
Occupational Therapy Assistant
Primary
OTA 319
CA
Other
Enumeration date
02/02/2015
Last updated
02/02/2015
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