Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 225X00000X | Occupational Therapist | 5729 | AZ |
NPI | 1003231036 |
---|---|
Provider Name | Sarah Ashley Miller |
First Address | Mesa, AZ 85206-6788 |
Second Address | Mesa, AZ 85206-6788 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 27/02/2014 |
Last Update Date | 27/02/2014 |