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Individual

ELIZABETH GRACE SCANLON

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
OTR/L

Contact information

Practice address
3731 SIXTH AVE, SUITE 103, SAN DIEGO, CA 92103
(858) 583-4993
Mailing address
3731 SIXTH AVE, SUITE 103, SAN DIEGO, CA 92103
(858) 583-4993

Taxonomy

Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
12824
CA
225X00000X
Occupational Therapist
275409
OR
225X00000X
Occupational Therapist
OR

Other

Enumeration date
06/09/2010
Last updated
12/10/2012
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