Individual
ANNA LEE THEBEAU
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
17490 N 93RD ST, SCOTTSDALE, AZ 85255-6323
(480) 588-5386
Mailing address
10888 N 70TH ST APT 171, SCOTTSDALE, AZ 85254-6114
(520) 409-0374
Taxonomy
Speciality
Code
Description
License number
State
224Z00000X
Occupational Therapy Assistant
Primary
OTA-006169
AZ
225X00000X
Occupational Therapist
OTA-006169
AZ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
OTA-006169
6169
AZ
Enumeration date
07/14/2020
Last updated
07/14/2020
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