Individual
MRS. THERESA MARIE FAKLER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
1722 E MARCONI AVE, PHOENIX, AZ 85022-3373
(602) 569-2803
Mailing address
1722 E MARCONI AVE, PHOENIX, AZ 85022-3373
(602) 569-2803
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
5286
AZ
Other
Enumeration date
07/10/2013
Last updated
07/10/2013
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