Individual
JASON NEEDHAM
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
20329 N 59TH AVE STE A2, GLENDALE, AZ 85308-6854
(480) 787-5387
Mailing address
PO BOX 7571, SURPRISE, AZ 85374-0109
Taxonomy
Speciality
Code
Description
License number
State
224Z00000X
Occupational Therapy Assistant
Primary
OTA-046880
AZ
Other
Enumeration date
01/07/2021
Last updated
01/07/2021
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