Individual
MRS. LIDIA SEROUSSI
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
OTR/L
Contact information
Practice address
1123 MILKY WAY, CUPERTINO, CA 95014-5064
(408) 257-9663
Mailing address
1123 MILKY WAY, CUPERTINO, CA 95014-5064
(408) 257-9663
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
C6344979
CA
Other
Enumeration date
09/09/2010
Last updated
09/09/2010
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