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TIFFANY BELOUSOV OTR/L

>> Occupational Therapist >> Respiratory, Developmental, Rehabilitative and Restorative Service Providers

Registrant NPI Number: 1831684638

Individual Registrant:
 TIFFANY  BELOUSOV OTR/L
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: --

Contact information for business:
6810 DI LUSSO DR APT 189  ELK GROVE, CA 95758-5889 US
Tel: 559-707-4797  Fax: --

Registration Information:
NPI: 1831684638
Entity Type: Individual

Specialty information:

PrimaryCodeCategory/DescriptionStateLicense Number
Y225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service Providers
Occupational Therapist
CA18320

Legacy codes, insurance codes and state license numbers:

IssuerNumberStateType




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