Provider Demographics
NPI:1255673513
Name:HALE, ADAH INEZ (OTR/L)
Entity Type:Individual
Prefix:MRS
First Name:ADAH
Middle Name:INEZ
Last Name:HALE
Suffix:
Gender:F
Credentials:OTR/L
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:15415 VAN BUREN ST
Mailing Address - Street 2:
Mailing Address - City:MIDWAY CITY
Mailing Address - State:CA
Mailing Address - Zip Code:92655-1608
Mailing Address - Country:US
Mailing Address - Phone:714-728-8752
Mailing Address - Fax:
Practice Address - Street 1:15415 VAN BUREN ST
Practice Address - Street 2:
Practice Address - City:MIDWAY CITY
Practice Address - State:CA
Practice Address - Zip Code:92655-1608
Practice Address - Country:US
Practice Address - Phone:714-728-8752
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-03-25
Last Update Date:2013-03-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA12945225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist