Individual
BRIANA ROQUE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
OTD, OTR/L
Contact information
Practice address
957 FAULKNER RD STE 105, SANTA PAULA, CA 93060-9129
(805) 765-4773
Mailing address
29154 MISSION TRAIL LN, VALENCIA, CA 91354-1526
(661) 476-7724
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
21898
CA
225XP0200X
Pediatric Occupational Therapist
OT-2604
NV
Other
Enumeration date
09/22/2020
Last updated
06/29/2021
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