Provider Demographics
NPI:1437320934
Name:MINTZ, JUNE MARGARET (OTR)
Entity Type:Individual
Prefix:
First Name:JUNE
Middle Name:MARGARET
Last Name:MINTZ
Suffix:
Gender:F
Credentials:OTR
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2500 GLENDOWER AVE
Mailing Address - Street 2:
Mailing Address - City:LOS ANGELES
Mailing Address - State:CA
Mailing Address - Zip Code:90027-1113
Mailing Address - Country:US
Mailing Address - Phone:323-666-3300
Mailing Address - Fax:323-663-3208
Practice Address - Street 1:7120 HAYVENHURST AVE
Practice Address - Street 2:SUITE 215
Practice Address - City:VAN NUYS
Practice Address - State:CA
Practice Address - Zip Code:91406-3843
Practice Address - Country:US
Practice Address - Phone:818-785-9515
Practice Address - Fax:818-785-9535
Is Sole Proprietor?:Yes
Enumeration Date:2008-03-12
Last Update Date:2008-03-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAOT496225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist