Individual
JESSICA BASHA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
DPT
Contact information
Practice address
3403 E MAIN ST # 208, MESA, AZ 85213-8683
(480) 848-4281
Mailing address
3600 W RAY RD, #2082, CHANDLER, AZ 85226-1372
(402) 321-0406
Taxonomy
Speciality
Code
Description
License number
State
2251P0200X
Pediatric Physical Therapist
Primary
6944
AZ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
961632
—
AZ
Enumeration date
12/19/2006
Last updated
03/08/2016
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