Doctor Name: | MRS. MARIA CONKLIN |
NPI Number: | 1497947816 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | COTA |
License Number: | 1744 |
Business Practice Address: | 4113 W Oraibi Dr Glendale, AZ - 853087424 |
Business Phone Number: | 6026146683 |
Business Fax Number: | |
Mailing Address: | 13835 N Tatum Blvd, Ste 9-429 PHOENIX |
State: | AZ |
Postal Code: | 850325590 |
Phone Number: | 4802047475 |
Fax Number: | 6026331076 |
NPI Enumeration Date: | 08/10/2007 |
NPI Last Update Date: | 05/29/2015 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 174400000X |
License Number: | 1744 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | AZ |
Taxonomy Type: | Other Service Providers |
Taxonomy Classification: | Specialist |
Taxonomy Specialization: | |
Taxonomy Definition: | An individual educated and trained in an applied knowledge discipline used in the performance of work at a level requiring knowledge and skills beyond or apart from that provided by a general education or liberal arts degree. |