Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 225XP0200X | Occupational Therapist - Pediatrics | 0569 | AZ |
NPI | 1043415714 |
---|---|
Provider Name | Tonya Lee Soules |
First Address | Scottsdale, AZ 85258-3207 |
Second Address | Scottsdale, AZ 85258-3207 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 20/06/2007 |
Last Update Date | 08/07/2007 |