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General NPI Number Information
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NPI Number | 1194500538
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Entity Type | Individual
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Provider Name | EMILY RENEE DANDRON OTR/L
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Gender | Female
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Dates
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Enumeration Date | 08/25/2023
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Last Update Date | 08/25/2023
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Provider Practice Location Address
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Address Line | 1225 W 190TH ST STE 1225
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City | GARDENA
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State | CA
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Zip | 90248-4320
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Country | US
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Telephone | 310-819-8060
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Fax |
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Provider Business Mailing Address
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Address Line | 211 YACHT CLUB WAY APT 323
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City | REDONDO BEACH
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State | CA
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Zip | 90277-2071
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Country | US
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Telephone | 734-625-0815
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 225XP0200X
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Taxonomy Name | Pediatric Occupational Therapist
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License Number | 5201010578
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License Number State | MI
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Taxonomy #2
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Taxonomy Code | 225XP0200X
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Taxonomy Name | Pediatric Occupational Therapist
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License Number | 25329
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License Number State | CA
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