Organization
FIESTA PEDIATRIC THERAPY
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. MARY ANN SHEELY (OWNER)
(602) 265-4124
Entity
Organization
Contact information
Practice address
930 W SOUTHERN AVE, SUITE 10, MESA, AZ 85210-4938
(480) 835-0857
(480) 898-0138
Mailing address
1641 E OSBORN RD, SUITE 1, PHOENIX, AZ 85016-7146
(602) 265-4124
(602) 248-8843
Taxonomy
Speciality
Code
Description
License number
State
2251P0200X
Pediatric Physical Therapist
—
—
225XP0200X
Pediatric Occupational Therapist
—
—
235Z00000X
Speech-Language Pathologist
Primary
—
—
Other
Enumeration date
11/22/2006
Last updated
09/11/2025
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