Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 225X00000X | Occupational Therapist | OTH-008342 | AZ |
NPI | 1003400771 |
---|---|
Provider Name | Christina Hyland |
First Address | Scottsdale, AZ 85251-6374 |
Second Address | Phoenix, AZ 85014-4085 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 23/02/2021 |
Last Update Date | 23/02/2021 |