Individual
MS. SUSAN GAYLE NESBIT
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
OTR/L
Contact information
Practice address
340 N MOUNT VERNON AVE, PRESCOTT, AZ 86301-2620
(928) 771-2406
Mailing address
315 E CARLETON ST APT D1, PRESCOTT, AZ 86303-3945
(928) 449-9935
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
4090
AZ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
4090
LICENSE
AZ
Enumeration date
03/18/2008
Last updated
03/18/2008
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