Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 225X00000X | Occupational Therapist | 1495 | HI |
Y | 225XN1300X | Occupational Therapist - Neurorehabilitation | 007223 | AZ |
NPI | 1497113633 |
---|---|
Provider Name | Ashley Prunty |
First Address | Tucson, AZ 85745-3939 |
Second Address | Tucson, AZ 85712-6106 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 02/02/2016 |
Last Update Date | 24/08/2021 |