Individual
LISA TELLEFSEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
1100 E MONROE ST, GLOBE, AZ 85501-1363
(928) 425-5721
Mailing address
1100 E MONROE ST, GLOBE, AZ 85501-1363
Taxonomy
Speciality
Code
Description
License number
State
224Z00000X
Occupational Therapy Assistant
Primary
1147
AZ
Other
Enumeration date
10/10/2011
Last updated
10/10/2011
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