Individual
MIMI PRUNISKI
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
OTL
Contact information
Practice address
8521 W CHERRY HILLS DR, PEORIA, AZ 85345-8170
(623) 487-8616
Mailing address
8521 W CHERRY HILLS DR, PEORIA, AZ 85345-8170
(623) 487-8616
Taxonomy
Speciality
Code
Description
License number
State
225XP0200X
Pediatric Occupational Therapist
Primary
516
AZ
Other
Enumeration date
11/21/2006
Last updated
07/08/2007
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