Provider Demographics
NPI:1386953081
Name:ILAO, GIRLIE ESPIRITU (OTR/L)
Entity type:Individual
Prefix:MS
First Name:GIRLIE
Middle Name:ESPIRITU
Last Name:ILAO
Suffix:
Gender:F
Credentials:OTR/L
Other - Prefix:MS
Other - First Name:GIRLIE
Other - Middle Name:MERCADO
Other - Last Name:ESPIRITU
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:2291 W 205TH ST
Mailing Address - Street 2:101
Mailing Address - City:TORRANCE
Mailing Address - State:CA
Mailing Address - Zip Code:90501-1451
Mailing Address - Country:US
Mailing Address - Phone:347-475-4388
Mailing Address - Fax:
Practice Address - Street 1:2291 W 205TH ST
Practice Address - Street 2:101
Practice Address - City:TORRANCE
Practice Address - State:CA
Practice Address - Zip Code:90501-1451
Practice Address - Country:US
Practice Address - Phone:347-475-4388
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2010-09-28
Last Update Date:2013-09-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY014879-1225X00000X
CAOT 13718225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist