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TIFFANY BELOUSOV OTR/L
>> Occupational Therapist >> Respiratory, Developmental, Rehabilitative and Restorative Service ProvidersRegistrant NPI Number: 1831684638
Individual Registrant: TIFFANY BELOUSOV OTR/L
Gender: F
Not Sole Proprietor
Gender: F
Not Sole Proprietor
Location and contact information for practice:
800 S HAM LN LODI, CA 95242-3543 US
Tel: 209-368-7141 Fax: --
Tel: 209-368-7141 Fax: --
Contact information for business:
6810 DI LUSSO DR APT 189 ELK GROVE, CA 95758-5889 US
Tel: 559-707-4797 Fax: --
Tel: 559-707-4797 Fax: --
Registration Information:
NPI: 1831684638
Entity Type: Individual
Entity Type: Individual
Specialty information:
| Primary | Code | Category/Description | State | License Number |
|---|---|---|---|---|
| Y | 225X00000X | Respiratory, Developmental, Rehabilitative and Restorative Service Providers Occupational Therapist | CA | 18320 |
Legacy codes, insurance codes and state license numbers:
| Issuer | Number | State | Type |
|---|---|---|---|
