Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 225X00000X | Occupational Therapist | 456525 |
NPI | 1003486184 |
---|---|
Provider Name | Cassie Maddigan |
First Address | Gilbert, AZ 85295-1850 |
Second Address | Queen Creek, AZ 85140-9312 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 30/06/2021 |
Last Update Date | 30/06/2021 |