Individual
RENEE THORNBURG
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
COTA
Contact information
Practice address
523 N MATLOCK ST, MESA, AZ 85203-7223
(480) 738-1481
Mailing address
523 N MATLOCK ST, MESA, AZ 85203-7223
(480) 738-1481
Taxonomy
Speciality
Code
Description
License number
State
224Z00000X
Occupational Therapy Assistant
Primary
6425
AZ
Other
Enumeration date
02/15/2016
Last updated
02/15/2016
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