Individual
ETHIE M TATE-QUINALTY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
OTR/L
Contact information
Practice address
7898 CALIFORNIA AVE, RIVERSIDE, CA 92504-2597
(951) 643-3699
Mailing address
7016 SVL BOX, VICTORVILLE, CA 92395-5107
(760) 953-9267
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
OT10656
CA
Other
Enumeration date
08/18/2020
Last updated
08/18/2020
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