Individual
MRS. TRACIE LEA CORDEIRO
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
COTA/L
Contact information
Practice address
2420 CARNIVAL DR, TURLOCK, CA 95380-8416
(209) 324-0939
Mailing address
2420 CARNIVAL DR, TURLOCK, CA 95380-8416
Taxonomy
Speciality
Code
Description
License number
State
224Z00000X
Occupational Therapy Assistant
Primary
495
CA
Other
Enumeration date
10/08/2019
Last updated
10/08/2019
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