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Individual

ANDREA J SLABAUGH

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
O.T.

Contact information

Practice address
2414 N TRENTON, MESA, AZ 85207-2527
(480) 380-2810
(480) 380-2861
Mailing address
2414 N TRENTON, MESA, AZ 85207-2527
(480) 380-2810
(480) 380-2861

Taxonomy

Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
3680
AZ

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
3680
OT LICENSE
AZ
Enumeration date
02/08/2007
Last updated
07/08/2007
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