Individual
KIANA G EOAS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
COTA/L
Contact information
Practice address
1130 LIBERTY ST SE STE 2, SALEM, OR 97302-4143
(503) 339-7781
Mailing address
1130 LIBERTY ST SE STE 2, SALEM, OR 97302-4143
Taxonomy
Speciality
Code
Description
License number
State
224Z00000X
Occupational Therapy Assistant
Primary
365316
OR
Other
Enumeration date
04/06/2019
Last updated
04/06/2019
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