Individual
TRACEY STAR DALY-GOLDBERG
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
OTR L
Contact information
Practice address
4030 E AGAVE RD, PHOENIX, AZ 85044-0608
(480) 239-0553
Mailing address
4030 E AGAVE RD, PHOENIX, AZ 85044-0608
(480) 239-0553
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
3114
AZ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
795817
—
AZ
Enumeration date
02/13/2007
Last updated
07/09/2007
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