Individual
MRS. JANE DESMOND CONNELY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
OTR/L
Contact information
Practice address
47 SANTA ROSA ST, SAN LUIS OBISPO, CA 93405-1811
(949) 433-8457
Mailing address
475 POA PL, SAN LUIS OBISPO, CA 93405-4768
(949) 433-8457
Taxonomy
Speciality
Code
Description
License number
State
225XN1300X
Neurorehabilitation Occupational Therapist
Primary
13961
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
13961
CBOT
CA
Enumeration date
09/07/2012
Last updated
02/21/2020
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