Individual
MISS JILLIAN BROOKE BOTHWELL
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
M.A.
Contact information
Practice address
1540 ALCAZAR STREET CHP 133, LOS ANGELES, CA 90089
(323) 442-2850
Mailing address
1540 ALCAZAR STREET CHP 133, LOS ANGELES, CA 90089
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
22980
CA
Other
Enumeration date
05/11/2021
Last updated
05/10/2022
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