Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 225100000X | Physical Therapist | 10431 | AZ |
N | 2251N0400X | Physical Therapist - Neurology | 10431 | AZ |
NPI | 1346753498 |
---|---|
Provider Name | Kathleen Gentili |
First Address | Scottsdale, AZ 85259-5452 |
Second Address | Scottsdale, AZ 85259-5452 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 12/11/2017 |
Last Update Date | 22/03/2019 |