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Individual

CHERYL S NELSON

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
O.T.

Contact information

Practice address
10450 W MCDOWELL RD, STE 102, AVONDALE, AZ 85392-4802
(623) 848-4687
(623) 848-4686
Mailing address
PO BOX 29870, PHOENIX, AZ 85038-9870
(602) 772-3805
(602) 772-3801

Taxonomy

Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
3Z3990
HEALTHNET ID
05
637738
AZ
01
P00845668
RAILROAD MEDICARE
AZ
Enumeration date
04/13/2007
Last updated
05/31/2013
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