Individual
KRISTEN DICICCO
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
OT, DOT
Contact information
Practice address
790 N ESTRELLA PKWY STE C, GOODYEAR, AZ 85338-9290
(602) 765-4348
(623) 233-6567
Mailing address
300 W CLARENDON AVE STE 285, PHOENIX, AZ 85013-3474
(602) 279-6905
(623) 233-6567
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
OTC9339
AZ
Other
Enumeration date
07/22/2022
Last updated
07/22/2022
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