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General NPI Number Information
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NPI Number | 1780911909
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Entity Type | Organization
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Legal Business Name | AS THEY GROW
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Dates
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Enumeration Date | 11/09/2009
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Last Update Date | 06/05/2013
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Provider Practice Location Address
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Address Line | 339 E ROWLAND ST
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City | COVINA
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State | CA
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Zip | 91723-3153
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Country | US
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Telephone | 626-339-0268
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Fax | 626-371-0423
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Provider Business Mailing Address
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Address Line | 339 E ROWLAND ST
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City | COVINA
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State | CA
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Zip | 91723-3153
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Country | US
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Telephone | 626-339-0268
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Fax | 626-371-0423
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Authorized Official
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Title or Position | PROVIDER
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Name | SYDEL KHOE
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Credential | OTR/L
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Telephone | 626-339-0268
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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 | OT 5376
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License Number State | CA
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