Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 225XP0200X | Occupational Therapist - Pediatrics | 2757 | AZ |
NPI | 1073746194 |
---|---|
Provider Name | Mrs. Abby Lee Ulrich |
First Address | Phoenix, AZ 85022-5227 |
Second Address | Phoenix, AZ 85022-5227 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 25/08/2009 |
Last Update Date | 25/08/2009 |