Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 225XH1200X | Occupational Therapist - Hand | 2613 | AZ |
NPI | 1073566113 |
---|---|
Provider Name | Stephen S Desjardins |
First Address | Scottsdale, AZ 85251-5210 |
Second Address | Scottsdale, AZ 85251-5210 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 18/05/2006 |
Last Update Date | 01/07/2013 |