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Organization

HEARD INNOVATIVE PEDIATRIC THERAPY, PLLC

Active
Other names
None
Organization subpart
No

Provider details

NPI number
Authorized official
MRS. ANGELA MICHELLE HEARD OTR/L (LICENSED OCCUPATIONAL THERAPIST)
(480) 241-7152
Entity
Organization

Contact information

Practice address
4700 E THOMAS RD, SUITE 100, PHOENIX, AZ 85018-7700
(602) 595-6683
(866) 659-7750
Mailing address
4700 E THOMAS RD, SUITE 100, PHOENIX, AZ 85018-7700
(602) 595-6683
(866) 659-7750

Taxonomy

Speciality
Code
Description
License number
State
225XP0200X
Pediatric Occupational Therapist
Primary
3331
AZ

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
080176
AHCCCS
AZ
01
1578699146
NPI
AZ
Enumeration date
02/26/2008
Last updated
02/26/2008
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