Individual
MS. LAURIE SUE NELSON WALLACE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
OTR/L
Contact information
Practice address
4045 E UNION HILLS DR STE 110, PHOENIX, AZ 85050
(602) 485-4444
Mailing address
11105 E SAHUARO DR, SCOTTSDALE, AZ 85259-3994
(480) 296-8115
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
4932
AZ
Other
Enumeration date
11/22/2011
Last updated
08/24/2018
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