Individual
MARY C WALKER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
COTA/L
Contact information
Practice address
2812 SILVER CREEK RD, BULLHEAD CITY, AZ 86442-8309
(928) 763-1404
Mailing address
3567 N IRVING ST, KINGMAN, AZ 86409-3121
Taxonomy
Speciality
Code
Description
License number
State
224Z00000X
Occupational Therapy Assistant
Primary
2360
AZ
Other
Enumeration date
09/29/2010
Last updated
09/29/2010
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