Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 225XG0600X | Occupational Therapist - Gerontology | 008025 | AZ |
NPI | 1700469194 |
---|---|
Provider Name | Breelyn Saner |
First Address | Scottsdale, AZ 85257-3565 |
Second Address | Phoenix, AZ 85054-5713 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 03/05/2021 |
Last Update Date | 03/05/2021 |