Individual
LACEY SHUPE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
OTRL
Contact information
Practice address
1046 W 9TH ST, TEMPE, AZ 85281-5303
(970) 672-6058
Mailing address
1046 W 9TH ST, TEMPE, AZ 85281-5303
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
5083
AZ
Other
Enumeration date
03/17/2014
Last updated
03/17/2014
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