Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 225XP0200X | Occupational Therapist - Pediatrics | 5341 | AZ |
NPI | 1003154139 |
---|---|
Provider Name | Kristina Nalder |
First Address | Phoenix, AZ 85024-6043 |
Second Address | Phoenix, AZ 85014-2805 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 24/01/2013 |
Last Update Date | 24/01/2013 |