Individual
MS. DIANA RAY ROBERTS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
COTA/L
Contact information
Practice address
3150 N WINDING BROOK RD, FLAGSTAFF, AZ 86001-0972
(928) 774-7106
Mailing address
3150 N WINDING BROOK RD, FLAGSTAFF, AZ 86001-0972
(928) 774-7106
Taxonomy
Speciality
Code
Description
License number
State
224Z00000X
Occupational Therapy Assistant
Primary
4660
AZ
Other
Enumeration date
07/14/2011
Last updated
07/14/2011
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