Individual
LORI GOODMAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
7502 PARKWAY DR UNIT 200, LA MESA, CA 91942-1758
(619) 507-2635
Mailing address
7502 PARKWAY DR UNIT 200, LA MESA, CA 91942-1758
Taxonomy
Speciality
Code
Description
License number
State
224Z00000X
Occupational Therapy Assistant
Primary
1725
CA
Other
Enumeration date
12/28/2009
Last updated
12/28/2009
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