Healthcare Provider Details

I. General information

NPI: 1548738412
Provider Name (Legal Business Name): ZALIKA WRIGHT
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 11/08/2018
Last Update Date: 11/08/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7080 N 19TH AVE
PHOENIX AZ
85021-8585
US

IV. Provider business mailing address

14326 N 151ST DR
SURPRISE AZ
85379-7000
US

V. Phone/Fax

Practice location:
  • Phone: 602-601-2401
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code224Z00000X
TaxonomyOccupational Therapy Assistant
License Number046671
License Number StateAZ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: