Individual
MRS. SUSAN ELAINE LIATSOS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
COTA/L
Contact information
Practice address
2116 E DALEY LN, PHOENIX, AZ 85024-7508
(602) 920-1599
Mailing address
2116 E DALEY LN, PHOENIX, AZ 85024-7508
(602) 920-1599
Taxonomy
Speciality
Code
Description
License number
State
224Z00000X
Occupational Therapy Assistant
Primary
3269
AZ
Other
Enumeration date
09/26/2010
Last updated
09/26/2010
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