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General NPI Number Information
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NPI Number | 1053649103
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Entity Type | Organization
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Legal Business Name | THERAPRO INC
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Dates
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Enumeration Date | 12/01/2009
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Last Update Date | 12/01/2009
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Provider Practice Location Address
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Address Line | 7031 SEAWIND DR
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City | LONG BEACH
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State | CA
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Zip | 90803-4315
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Country | US
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Telephone | 562-799-0939
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Fax | 562-799-0933
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Provider Business Mailing Address
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Address Line | 7031 SEAWIND DR
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City | LONG BEACH
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State | CA
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Zip | 90803-4315
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Country | US
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Telephone | 562-799-0939
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Fax | 562-799-0933
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Authorized Official
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Title or Position | PRESIDENT
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Name | MRS. MYRRHA MARIANO
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Credential | OTR
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Telephone | 562-714-0939
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 225X00000X
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Taxonomy Name | Occupational Therapist
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License Number | 3806
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License Number State | CA
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