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Individual
CARLY TENGES RUSEK-PETERSON
Active
Individual
CARLY TENGES RUSEK-PETERSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
OTD, OTR/L, ATP
Taxonomy
Speciality
Code
Description
License number
State
225CA2400X
Assistive Technology Practitioner Rehabilitation Counselor
96511
AZ
225XP0019X
Physical Rehabilitation Occupational Therapist
Primary
OTH-008394
AZ
Other
Enumeration date
06/24/2024
Last updated
07/02/2024
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