Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 225XP0200X | Occupational Therapist - Pediatrics | 2410 | AZ |
NPI | 1063544872 |
---|---|
Provider Name | Cheryl Ray |
First Address | Phoenix, AZ 85048-7916 |
Second Address | Tempe, AZ 85282-3853 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 09/03/2007 |
Last Update Date | 08/07/2007 |