Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 225XN1300X | Occupational Therapist - Neurorehabilitation | 3616 | AZ |
NPI | 1528412509 |
---|---|
Provider Name | Mrs. Christine Syfu Beecham |
First Address | Phoenix, AZ 85006-2749 |
Second Address | Phoenix, AZ 85006-2749 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 15/04/2016 |
Last Update Date | 15/04/2016 |