Individual
ARLENE FORMANES
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
12881 KNOTT ST STE 103, GARDEN GROVE, CA 92841-3939
(714) 892-6828
Mailing address
12881 KNOTT ST STE 103, GARDEN GROVE, CA 92841-3939
Taxonomy
Speciality
Code
Description
License number
State
225XP0200X
Pediatric Occupational Therapist
Primary
14674
CA
Other
Enumeration date
10/15/2014
Last updated
10/15/2014
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