Healthcare Provider Details

I. General information

NPI: 1245336882
Provider Name (Legal Business Name): MARJORIE POMFRET OTR, CHT
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/14/2006
Last Update Date: 09/24/2012
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

13840 N NORTHSIGHT BLVD SUITE 121
SCOTTSDALE AZ
85260-3665
US

IV. Provider business mailing address

13840 N NORTHSIGHT BLVD SUITE 121
SCOTTSDALE AZ
85260-3665
US

V. Phone/Fax

Practice location:
  • Phone: 480-860-8380
  • Fax: 480-451-8318
Mailing address:
  • Phone: 480-860-8380
  • Fax: 480-451-8318

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225XH1200X
TaxonomyHand Occupational Therapist
License Number0246
License Number StateAZ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: