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Individual

HILIARY A FANTASIA

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
OT

Contact information

Practice address
1101 STROUD AVE, KINGSBURG, CA 93631-1016
(315) 415-3437
Mailing address
1101 STROUD AVE, KINGSBURG, CA 93631-1016
(315) 415-3437

Taxonomy

Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
016095-1
NY
225X00000X
Occupational Therapist
Primary
18275
CA

Other

Enumeration date
07/20/2009
Last updated
04/16/2018
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