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Individual

MS. DIANE MARIE HALL

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
OTR

Contact information

Practice address
VA MEDICAL CENTER, 650 E. INDIAN SCHOOL RD., PHOENIX, AZ 85012-1892
(602) 277-5551
Mailing address
1523 S MONTEREY ST, GILBERT, AZ 85233-8441
(480) 855-0740

Taxonomy

Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
0020
SD

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
0020
STATE OT LICENSE
SD
Enumeration date
07/10/2006
Last updated
07/08/2007
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