Individual
LISA MARIE RIOS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
COTA/L
Contact information
Practice address
2030 EVERGREEN AVE, MODESTO, CA 95350-3785
(209) 577-1055
Mailing address
5320 BENJAMIN CT, RIVERBANK, CA 95367-9469
(916) 995-3774
Taxonomy
Speciality
Code
Description
License number
State
224Z00000X
Occupational Therapy Assistant
Primary
4771
CA
Other
Enumeration date
04/04/2019
Last updated
04/04/2019
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