Healthcare Provider Details

I. General information

NPI: 1962792655
Provider Name (Legal Business Name): PATRICIA ANN AHLER MT-BC
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 04/14/2011
Last Update Date: 04/14/2011
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8510 S GRANDVIEW AVE
TEMPE AZ
85284-2382
US

IV. Provider business mailing address

8510 S GRANDVIEW AVE
TEMPE AZ
85284-2382
US

V. Phone/Fax

Practice location:
  • Phone: 602-361-8848
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225A00000X
TaxonomyMusic Therapist
License Number09810
License Number StateAZ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: