Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 225XP0200X | Occupational Therapist - Pediatrics | 4853 | AZ |
NPI | 1063785913 |
---|---|
Provider Name | Sarah Weiner |
First Address | Phoenix, AZ 85014-1931 |
Second Address | Phoenix, AZ 85016-2903 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 22/02/2012 |
Last Update Date | 22/02/2012 |