Individual
DONNA EVANS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
COTA
Contact information
Practice address
2704 W KILAREA AVE, MESA, AZ 85202-6378
(480) 413-0642
Mailing address
2704 W KILAREA AVE, MESA, AZ 85202-6378
(480) 413-0642
Taxonomy
Speciality
Code
Description
License number
State
224Z00000X
Occupational Therapy Assistant
Primary
1570
AZ
Other
Enumeration date
08/07/2007
Last updated
08/07/2007
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