Provider Demographics
NPI:1811491897
Name:INOUE, KUMIKO (OTR/L)
Entity type:Individual
Prefix:
First Name:KUMIKO
Middle Name:
Last Name:INOUE
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 1:439 W GLADSTONE ST APT E
Mailing Address - Street 2:
Mailing Address - City:GLENDORA
Mailing Address - State:CA
Mailing Address - Zip Code:91740-5562
Mailing Address - Country:US
Mailing Address - Phone:626-589-7980
Mailing Address - Fax:
Practice Address - Street 1:439 W GLADSTONE ST APT E
Practice Address - Street 2:
Practice Address - City:GLENDORA
Practice Address - State:CA
Practice Address - Zip Code:91740-5562
Practice Address - Country:US
Practice Address - Phone:626-589-7980
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-03-22
Last Update Date:2018-09-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225XP0200XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistPediatrics