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General NPI Number Information
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NPI Number | 1780948901
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Entity Type | Organization
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Legal Business Name | HEALING HORSES EQUINE ASSISTED ACTIVITIES AND THERAPY
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Dates
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Enumeration Date | 07/03/2012
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Last Update Date | 07/03/2012
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Provider Practice Location Address
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Address Line | 19601 N 38TH AVE
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City | GLENDALE
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State | AZ
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Zip | 85308-2216
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Country | US
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Telephone | 623-476-2862
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Fax |
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Provider Business Mailing Address
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Address Line | 19601 N 38TH AVE
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City | GLENDALE
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State | AZ
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Zip | 85308-2216
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Country | US
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Telephone | 623-476-2862
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | MRS. SHERI BLAIR-SCOVILL
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Credential | COTA-L
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Telephone | 623-476-2862
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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 | 1686
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License Number State | AZ
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