Provider Demographics
NPI:1366187007
Name:HOVANISSIAN, LILIT SIRIK (MSOT, OTR/L)
Entity type:Individual
Prefix:MS
First Name:LILIT
Middle Name:SIRIK
Last Name:HOVANISSIAN
Suffix:
Gender:F
Credentials:MSOT, OTR/L
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1801 N GRAMERCY PL APT 1
Mailing Address - Street 2:
Mailing Address - City:LOS ANGELES
Mailing Address - State:CA
Mailing Address - Zip Code:90028-5817
Mailing Address - Country:US
Mailing Address - Phone:213-622-0045
Mailing Address - Fax:
Practice Address - Street 1:1801 N GRAMERCY PL APT 1
Practice Address - Street 2:
Practice Address - City:LOS ANGELES
Practice Address - State:CA
Practice Address - Zip Code:90028-5817
Practice Address - Country:US
Practice Address - Phone:213-622-0045
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-04-27
Last Update Date:2022-04-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAOT23474225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist