Individual
NICOLE PRUETT
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
15802 N PARKVIEW PL, SURPRISE, AZ 85374-7466
(623) 876-7000
Mailing address
15802 N PARKVIEW PL, SURPRISE, AZ 85374-7466
(623) 876-7000
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
OTH-007846
AZ
Other
Enumeration date
07/31/2019
Last updated
07/31/2019
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