Individual
CASEY ELIZABETH CONVERSE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
OT
Contact information
Practice address
3760 CONVOY ST STE 204, SAN DIEGO, CA 92111-3744
(858) 514-0375
Mailing address
3760 CONVOY ST STE 204, SAN DIEGO, CA 92111-3744
(858) 514-0375
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
OT14361
CA
Other
Enumeration date
05/25/2017
Last updated
07/21/2022
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