Individual
NICOLE HARLEY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
OTR/L
Contact information
Practice address
1190 E MISSOURI AVE STE 100, PHOENIX, AZ 85014-2719
(602) 393-0520
Mailing address
809 W GROVE PKWY APT 2104, TEMPE, AZ 85283-8449
(425) 984-4394
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
4854
AZ
Other
Enumeration date
07/12/2011
Last updated
07/12/2011
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