Individual
MS. LALANA LYNN FENNELL
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
330 GOLDEN SHR STE 250, LONG BEACH, CA 90802-4270
(562) 256-7550
(562) 256-7550
Mailing address
330 GOLDEN SHR STE 250, LONG BEACH, CA 90802-4270
(562) 256-7550
(562) 256-7550
Taxonomy
Speciality
Code
Description
License number
State
224Z00000X
Occupational Therapy Assistant
Primary
2358
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
2358
—
CA
Enumeration date
01/15/2013
Last updated
01/15/2013
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