Individual
MRS. ELLEN BAUER HUME
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MA, OTR/L
Contact information
Practice address
3820 MARTIN LUTHER KING JR BLVD, LYNWOOD, CA 90262-3625
(310) 632-0415
Mailing address
2945 RAYMOND AVE, LOS ANGELES, CA 90007-2846
(323) 356-1191
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
OT389
CA
225XG0600X
Gerontology Occupational Therapist
OT389
CA
225XN1300X
Neurorehabilitation Occupational Therapist
OT389
CA
225XP0019X
Physical Rehabilitation Occupational Therapist
OT389
CA
Other
Enumeration date
07/30/2015
Last updated
07/30/2015
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