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Individual

SARA WALLACE

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
MS, OTR/L

Contact information

Practice address
121 ROUNDUP RD, GLENDORA, CA 91741-3841
(626) 502-7645
Mailing address
121 ROUNDUP RD, GLENDORA, CA 91741-3841
(626) 502-7645

Taxonomy

Speciality
Code
Description
License number
State
225XP0200X
Pediatric Occupational Therapist
Primary
22690
CA

Other

Enumeration date
12/18/2025
Last updated
12/18/2025
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