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General NPI Number Information
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NPI Number | 1306305131
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Entity Type | Individual
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Provider Name | JUDY SU-LE OTR/L
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Gender | Female
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Dates
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Enumeration Date | 03/19/2019
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Last Update Date | 03/19/2019
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Provider Practice Location Address
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Address Line | 8501 WILSHIRE BLVD STE 336
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City | BEVERLY HILLS
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State | CA
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Zip | 90211-3134
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Country | US
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Telephone | 310-659-9511
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Fax |
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Provider Business Mailing Address
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Address Line | 13761 LA PAT PL APT B
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City | WESTMINSTER
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State | CA
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Zip | 92683-8814
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Country | US
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Telephone | 714-725-2374
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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 | 19647
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License Number State | CA
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