Individual
MRS. DENISE ABANSADO MODOLO
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MOT/OTR/L
Contact information
Practice address
412 REDHILL AVE, #1, SAN ANSELMO, CA 94960
(415) 457-4409
(415) 488-9781
Mailing address
7 SOUTH KNOLL RD, #4, MILL VALLEY, CA 94941
(415) 260-5576
Taxonomy
Speciality
Code
Description
License number
State
225XP0200X
Pediatric Occupational Therapist
Primary
OT2563
CA
Other
Enumeration date
01/21/2009
Last updated
01/21/2009
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