Individual
MS. KRISTINE ELAYNE BOETEL
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
COTAL
Contact information
Practice address
2220 S COUNTRY CLUB, #104, MESA, AZ 85210
(480) 820-6366
(480) 820-0462
Mailing address
PO BOX 6397, CHANDLER, AZ 85246
(480) 820-6366
(480) 820-0462
Taxonomy
Speciality
Code
Description
License number
State
224Z00000X
Occupational Therapy Assistant
Primary
1909
AZ
Other
Enumeration date
12/13/2006
Last updated
07/08/2007
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