Individual
MRS. KIM ANN WIESER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
COTA
Contact information
Practice address
7540 N 19TH AVE STE 200, PHOENIX, AZ 85021-7967
(888) 873-4221
(888) 543-2289
Mailing address
7540 N 19TH AVE STE 200, PHOENIX, AZ 85021-7967
(888) 873-4221
(888) 543-2289
Taxonomy
Speciality
Code
Description
License number
State
224Z00000X
Occupational Therapy Assistant
Primary
201657
MN
Other
Enumeration date
10/21/2010
Last updated
10/21/2010
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