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General NPI Number Information
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NPI Number | 1235252479
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Entity Type | Individual
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Provider Name | BERTHA BROWN HOLLIDAY O.T.R.L.
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Gender | Female
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Dates
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Enumeration Date | 04/10/2007
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Last Update Date | 07/08/2007
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Provider Practice Location Address
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Address Line | 13652 CANTARA ST. BALBOA PLAZA
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City | PANORAMA CITY
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State | CA
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Zip | 91492
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Country | US
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Telephone | 818-832-7200
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 5654
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City | PASADENA
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State | CA
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Zip | 91117-0654
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Country | US
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Telephone | 626-392-5634
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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 | 225X00000X
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Taxonomy Name | Occupational Therapist
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License Number | 6947
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License Number State | CA
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