Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 225X00000X | Occupational Therapist | 0430 | AZ |
N | 225XH1200X | Occupational Therapist - Hand | 0430 | AZ |
N | 225XN1300X | Occupational Therapist - Neurorehabilitation | 0430 | AZ |
NPI | 1790993723 |
---|---|
Provider Name | Tara Lynne Wigal-Wertsching |
First Address | Scottsdale, AZ 85254-5614 |
Second Address | Scottsdale, AZ 85250-4819 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 21/05/2007 |
Last Update Date | 08/07/2007 |