Individual
MIRANDA J RIESGO
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
OTD, OTR/L
Contact information
Practice address
1000 E NARRAMORE AVE, BUCKEYE, AZ 85326-2632
(520) 429-1953
Mailing address
3808 N 30TH ST, PHOENIX, AZ 85016-6902
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
OTH-008868
AZ
Other
Enumeration date
07/22/2022
Last updated
07/22/2022
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