Individual
MIRINISA FORTUNATO
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
COTA
Contact information
Practice address
8850 E PIMA CENTER PKWY, SCOTTSDALE, AZ 85258-4619
(480) 800-3900
(717) 412-9480
Mailing address
3813 W IVANHOE ST, CHANDLER, AZ 85226-2212
Taxonomy
Speciality
Code
Description
License number
State
224Z00000X
Occupational Therapy Assistant
Primary
5836
AZ
Other
Enumeration date
06/16/2014
Last updated
03/18/2021
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