Individual
MISS BOGUSLAWA TERESA SYROTIAK
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
16257 LAGUNA CANYON ROAD, SUITE 150, IRVINE, CA 92618
(949) 727-2192
Mailing address
21802 MICHIGAN LANE, LAKE FOREST, CA 92630
(626) 831-8182
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
9987
CA
Other
Enumeration date
05/09/2008
Last updated
05/09/2008
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