Individual
DIANA THIES
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MOT, OTR/L
Contact information
Practice address
1802 W PARKSIDE LN, PHOENIX, AZ 85027-1322
(602) 943-5472
Mailing address
1802 W PARKSIDE LN, PHOENIX, AZ 85027-1322
(602) 943-5472
Taxonomy
Speciality
Code
Description
License number
State
225XP0200X
Pediatric Occupational Therapist
Primary
4317
AZ
Other
Enumeration date
11/19/2015
Last updated
11/19/2015
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