Individual
MISS HEATHER JEAN TATE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
COTA/L
Contact information
Practice address
29133 N SHANNON DR, SAN TAN VLY, AZ 85143-3968
(602) 723-3016
Mailing address
29133 N SHANNON DR, SAN TAN VLY, AZ 85143-3968
(602) 723-3016
Taxonomy
Speciality
Code
Description
License number
State
224Z00000X
Occupational Therapy Assistant
Primary
OTA-046667
AZ
Other
Enumeration date
10/26/2018
Last updated
10/26/2018
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