Individual
STEPHANIE KIDDER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
1745 S ALMA SCHOOL RD STE 145, MESA, AZ 85210-3049
(480) 963-3436
Mailing address
67 E ROANOKE AVE APT 16, PHOENIX, AZ 85004-1080
(623) 293-1032
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
—
—
Other
Enumeration date
05/31/2019
Last updated
05/31/2019
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