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General NPI Number Information
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NPI Number | 1265955876
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Entity Type | Organization
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Legal Business Name | TINY TOTS OCCUPATIONAL THERAPY, INC.
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Dates
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Enumeration Date | 07/25/2017
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Last Update Date | 07/25/2017
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Provider Practice Location Address
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Address Line | 207 AVENUE D
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City | REDONDO BEACH
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State | CA
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Zip | 90277-4911
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Country | US
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Telephone | 201-981-2704
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Fax |
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Provider Business Mailing Address
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Address Line | 207 AVENUE D
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City | REDONDO BEACH
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State | CA
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Zip | 90277-4911
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | PRESIDENT
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Name | MS. REBECCA ANN ZINO
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Credential | OTR/L
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Telephone | 201-981-2704
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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 | OT10498
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License Number State | CA
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