Individual
MELISSA PERU
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
2781 OSBORN DR, LAKE HAVASU CITY, AZ 86406-8629
(928) 505-5552
Mailing address
479 RED ROCK RD, SILVER CITY, NM 88061-9274
Taxonomy
Speciality
Code
Description
License number
State
224Z00000X
Occupational Therapy Assistant
Primary
5125
AZ
Other
Enumeration date
06/07/2013
Last updated
06/07/2013
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