Individual
MRS. MICHELLE COMPTON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
COTA/L
Contact information
Practice address
2585 MIRACLE MILE ROAD, UNIT #124, BULLHEAD CITY, AZ 86442
(928) 763-4030
(928) 854-5440
Mailing address
1515 N. LAKE HAVASU AVENUE, SUITE #100, LAKE HAVASU CITY, AZ 86404
(928) 854-5439
(928) 854-5440
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
—
—
224Z00000X
Occupational Therapy Assistant
Primary
6266
AZ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
6266
ARIZONA STATE BOARD OF OCCUPATIONAL THERAPY
AZ
Enumeration date
06/16/2016
Last updated
11/27/2017
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