Individual
JULIE FALDMO NILSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MA,OTR/L
Contact information
Practice address
22241 EVENING STAR CT, SANTA CLARITA, CA 91390-5765
(661) 373-8738
Mailing address
22241 EVENING STAR CT, SANTA CLARITA, CA 91390-5765
(661) 297-9315
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
OT6110
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1047579
NBCOT
—
01
—
OT6110
CA STATE LICENSING BOARD
CA
Enumeration date
05/14/2020
Last updated
05/14/2020
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