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Individual

MRS. ASHLEY BENFORD

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
OTD/OTR/L

Contact information

Practice address
167 N MAIN ST, TUBA CITY, AZ 86045
(928) 283-2501
(928) 283-2095
Mailing address
PO BOX 600, TUBA CITY, AZ 86045-0600
(928) 283-2501
(928) 283-2095

Taxonomy

Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
OTH-007842
AZ

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
568162
AZ
01
TEZ7BP
MEDICARE
AZ
Enumeration date
07/24/2019
Last updated
04/22/2020
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