NPI 1619419009

Jennifer Deatherage

Practitioner Occupational Therapy Assistant Show Low, AZ

Practice location

Address: 2401 E Hunt Dr, Show Low, AZ 85901-7920
Phone: (928) 537-5333

Registered specialties

Occupational Therapy Assistant Primary

Respiratory, Developmental, Rehabilitative and Restorative Service Providers Taxonomy 224Z00000X Licence 6718 (AZ)

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Registry record

NPI: 1619419009
Entity type: Individual
Sex (as registered): Male
NPI issued: 16 Nov 2016
Record last updated: 16 Nov 2016

Reproduced from NPPES, the federal provider registry. The date above is when the provider last updated their own entry, not when we fetched it - a record can be years old and still current in the registry.