Individual
MR. DEREK JERRED KENT
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
COTA/L
Contact information
Practice address
3305 E FRY BLVD, SIERRA VISTA, AZ 85635-2990
(520) 515-2754
Mailing address
600 CHARLES DR APT 232, SIERRA VISTA, AZ 85635-1193
(916) 729-9600
Taxonomy
Speciality
Code
Description
License number
State
224Z00000X
Occupational Therapy Assistant
Primary
OTA-046990
AZ
Other
Enumeration date
08/17/2021
Last updated
08/17/2021
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