Individual
AMBER KAY PARK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
10251 N 35TH AVE, PHOENIX, AZ 85051-1305
(602) 995-7366
Mailing address
14237 W WETHERSFIELD RD, SURPRISE, AZ 85379-5541
(509) 998-9930
Taxonomy
Speciality
Code
Description
License number
State
225XP0200X
Pediatric Occupational Therapist
Primary
3754
AZ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
214426
CERTIFICATION
—
Enumeration date
11/01/2006
Last updated
07/08/2007
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