Individual
TAYLOR NICOLE CHURCH
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
551 S HIGLEY RD, MESA, AZ 85206-2148
(480) 892-9777
Mailing address
551 S HIGLEY RD, MESA, AZ 85206-2148
(808) 929-7777
(480) 635-0222
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
OTH-009532
AZ
225XP0200X
Pediatric Occupational Therapist
OTH-009532
AZ
Other
Enumeration date
02/08/2024
Last updated
02/08/2024
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