Individual
BONITA FAYE DALTON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.S.,OTR/L
Contact information
Practice address
294 W CARLOS AVE, HOLBROOK, AZ 86025-1846
(928) 524-2123
Mailing address
PO BOX 7782, SUN CITY, FL 33586-7782
(813) 505-2518
Taxonomy
Speciality
Code
Description
License number
State
225XP0200X
Pediatric Occupational Therapist
Primary
3109
AZ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
807-208
—
AZ
Enumeration date
09/20/2006
Last updated
08/17/2022
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