Basic Information
| Provider Information | |||||||||
| NPI: | 1639456742 | ||||||||
| EntityType: | 1 | ||||||||
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| LastName: | KOHN | ||||||||
| FirstName: | NURITH | ||||||||
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| Credential: | MA OTR/L | ||||||||
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| Mailing Information | |||||||||
| Address1: | 14016 BORA BORA WAY APT 339 | ||||||||
| Address2: | |||||||||
| City: | MARINA DEL REY | ||||||||
| State: | CA | ||||||||
| PostalCode: | 902926800 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 3108693644 | ||||||||
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| Practice Location | |||||||||
| Address1: | 8717 VENICE BLVD | ||||||||
| Address2: | |||||||||
| City: | LOS ANGELES | ||||||||
| State: | CA | ||||||||
| PostalCode: | 900343216 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 3103377115 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 11/03/2011 | ||||||||
| LastUpdateDate: | 11/03/2011 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 225X00000X | 12100 | CA | Y | Respiratory, Developmental, Rehabilitative and Restorative Service Providers | Occupational Therapist | 225XP0200X | 12100 | CA | N | Respiratory, Developmental, Rehabilitative and Restorative Service Providers | Occupational Therapist | Pediatrics |
No ID Information.