Healthcare Provider Details

I. General information

NPI: 1346806544
Provider Name (Legal Business Name): WENDY LYNN ABURTO
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/13/2019
Last Update Date: 05/13/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2012 W SOUTHERN AVE
APACHE JUNCTION AZ
85120-7305
US

IV. Provider business mailing address

2539 E HEATHERBRAE DR
PHOENIX AZ
85016
US

V. Phone/Fax

Practice location:
  • Phone: 480-983-0700
  • Fax:
Mailing address:
  • Phone: 605-786-4281
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code224Z00000X
TaxonomyOccupational Therapy Assistant
License Number7059
License Number StateAZ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: