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Organization

GYE DI

Active
Organization subpart
No

Provider details

NPI number
Authorized official
MELANIE CONATSER OTR/L (CHIEF EXECUTIVE OFFICER)
(602) 793-9676
Entity
Organization

Contact information

Practice address
2880 E CRESCENT WAY, GILBERT, AZ 85298-8762
(602) 793-9676
Mailing address
2880 E CRESCENT WAY, GILBERT, AZ 85298-8762
(602) 793-9676

Taxonomy

Speciality
Code
Description
License number
State
224Z00000X
Occupational Therapy Assistant
225XN1300X
Neurorehabilitation Occupational Therapist
225XP0019X
Physical Rehabilitation Occupational Therapist
225XP0200X
Pediatric Occupational Therapist
Primary

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
1427119304
AZ
05
1477025229
AZ
05
1497386809
AZ
Enumeration date
01/04/2021
Last updated
01/04/2021
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