Individual
MRS. REBECCA LANGE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
OTR
Contact information
Practice address
9638 W BUTLER DR, PEORIA, AZ 85345-7711
(608) 206-4387
Mailing address
9638 W BUTLER DR, PEORIA, AZ 85345-7711
(608) 206-4387
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
OTH-006608
AZ
Other
Enumeration date
09/15/2020
Last updated
09/15/2020
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