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General NPI Number Information
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NPI Number | 1750893749
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Entity Type | Individual
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Provider Name | JASMINE WARD-DYER OTR/L
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Gender | Female
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Dates
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Enumeration Date | 10/30/2017
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Last Update Date | 11/04/2020
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Provider Practice Location Address
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Address Line | 1100 S HILL ST APT 619
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City | LOS ANGELES
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State | CA
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Zip | 90015-4678
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Country | US
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Telephone | 424-326-3616
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Fax | 132-379-7506
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Provider Business Mailing Address
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Address Line | 1100 S HILL ST APT 619
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City | LOS ANGELES
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State | CA
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Zip | 90015-4678
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Country | US
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Telephone | 424-326-3616
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Fax | 323-797-5064
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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 | 60799680
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License Number State | WA
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Taxonomy #2
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Taxonomy Code | 225X00000X
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Taxonomy Name | Occupational Therapist
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License Number | 19314
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License Number State | CA
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