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Individual

MS. MARTHA FERGUSON

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
OTA/L

Contact information

Practice address
7660 WYNGATE ST, TUJUNGA, CA 91042-1736
(818) 352-1454
Mailing address
8968 DORRINGTON AVE, ARLETA, CA 91331-6122
(818) 489-5229

Taxonomy

Speciality
Code
Description
License number
State
224Z00000X
Occupational Therapy Assistant
Primary
OTA 639
CA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
1054840
NATIONAL BOARD FOR CERTIFICATION IN OCCUPATIONAL THERAPY
01
OTA 639
STATE LICENSURE
CA
Enumeration date
02/13/2015
Last updated
02/13/2015
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