Individual
MRS. ALYSSA THANADABOUTH
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
M.S. OTR/L
Contact information
Practice address
2115 J ST, STE 210, SACRAMENTO, CA 95816-4738
(916) 444-0033
Mailing address
150 CAFARO CIR, SACRAMENTO, CA 95834-1038
(209) 607-8927
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
13731
CA
Other
Enumeration date
10/10/2013
Last updated
07/21/2022
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