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General NPI Number Information
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NPI Number | 1730096405
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Entity Type | Individual
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Provider Name | MEMRIE SLOAN LANEY
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Gender | Female
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Dates
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Enumeration Date | 08/26/2026
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Last Update Date | 08/26/2026
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Provider Practice Location Address
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Address Line | 5535 N 67TH AVE
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City | GLENDALE
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State | AZ
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Zip | 85301-8214
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Country | US
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Telephone | 623-237-4006
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Fax |
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Provider Business Mailing Address
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Address Line | 123 COUNTY R0AD 1439
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City | MOOREVILLE
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State | MS
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Zip | 38857-7809
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Country | US
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Telephone | 662-646-0863
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 225X00000X
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Taxonomy Name | Occupational Therapist
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License Number | OTH-010421
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License Number State | AZ
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