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Organization

EARTH ANGELS THERAPY, LLC

Active
Organization subpart
No

Provider details

NPI number
Authorized official
MS. NANCY ANN PALATNIK OTR/L (OWNER)
(623) 521-5387
Entity
Organization

Contact information

Practice address
10101 N 91ST AVE, #112, PEORIA, AZ 85345-8335
(623) 521-5387
(866) 896-0786
Mailing address
10101 N 91ST AVE, #112, PEORIA, AZ 85345-8335
(623) 521-5387
(866) 896-0786

Taxonomy

Speciality
Code
Description
License number
State
225XP0200X
Pediatric Occupational Therapist
Primary
0311
AZ

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
987688
AHCCCS PROVIDER
AZ
Enumeration date
09/24/2006
Last updated
08/02/2007
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