Individual
MS. TIMARIE FAY MAKI
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
COTA/L
Contact information
Practice address
9415 N 99TH AVE APT 2042, PEORIA, AZ 85345-6939
(916) 588-5206
Mailing address
9415 N 99TH AVE APT 2042, PEORIA, AZ 85345-6939
(916) 588-5206
Taxonomy
Speciality
Code
Description
License number
State
224Z00000X
Occupational Therapy Assistant
Primary
D10289718
AZ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
224Z00000X
—
AZ
Enumeration date
10/25/2018
Last updated
10/25/2018
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