Individual
IAN MARCUS HENRY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
COTA
Contact information
Practice address
17100 E SHEA BLVD STE 600, FOUNTAIN HILLS, AZ 85268-6663
(480) 837-4565
Mailing address
17100 E SHEA BLVD STE 600, FOUNTAIN HILLS, AZ 85268-6663
(480) 837-4565
Taxonomy
Speciality
Code
Description
License number
State
224Z00000X
Occupational Therapy Assistant
Primary
047076
AZ
Other
Enumeration date
06/08/2022
Last updated
06/08/2022
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