Individual
CAROLINE PALMQUIST
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
COTA/L
Contact information
Practice address
2812 SILVER CREEK RD, BULLHEAD CITY, AZ 86442-8309
(928) 763-1404
Mailing address
6163 N STOCKTON HILL RD, KINGMAN, AZ 86409-9304
(928) 757-5097
Taxonomy
Speciality
Code
Description
License number
State
224Z00000X
Occupational Therapy Assistant
Primary
3784
AZ
Other
Enumeration date
12/19/2011
Last updated
12/19/2011
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