Individual
THEODORA CHAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MSOT, OTR/L
Contact information
Practice address
116 E WALNUT AVE, MONROVIA, CA 91016-3431
(626) 357-9934
Mailing address
116 E WALNUT AVE, MONROVIA, CA 91016-3431
Taxonomy
Speciality
Code
Description
License number
State
225XP0200X
Pediatric Occupational Therapist
Primary
21682
CA
Other
Enumeration date
10/29/2020
Last updated
10/29/2020
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