Individual
SUSAN DEBORAH MARK
Active
Sole proprietor
Provider details
NPI number
Gender
F
Contact information
Practice address
200 W SANTA ANA BLVD, #100, SANTA ANA, CA 92701-4134
(714) 647-0300
Mailing address
28411 BOTORRITA, MISSION VIEJO, CA 92692-2230
Taxonomy
Speciality
Code
Description
License number
State
225XP0200X
Pediatric Occupational Therapist
Primary
OT 903
CA
Other
Enumeration date
06/01/2006
Last updated
07/08/2007
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