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Individual

LIESL LADUKE

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
COTA

Contact information

Practice address
6550 E 2ND ST STE B, PRESCOTT VALLEY, AZ 86314-3523
(928) 771-9327
Mailing address
3800 N TANI RD APT B, PRESCOTT VALLEY, AZ 86314-1129
(217) 274-6721

Taxonomy

Speciality
Code
Description
License number
State
224Z00000X
Occupational Therapy Assistant
Primary
AZ

Other

Enumeration date
08/22/2017
Last updated
08/22/2017
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