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NPI Code Detail

MEDICARE: JOSELYN STURGIS FENLEY MOTL

MEDICARE:   JOSELYN STURGIS FENLEY  MOTL
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1225X00000XOccupational Therapist2804AZ
2225X00000XOccupational Therapist107843TX

General Provider Information

NPI Number : 1508085697
Entity Type Code : Individual
Provider Name (Legal Business Name) : JOSELYN STURGIS FENLEY MOTL
Provider Business Mailing Address
First Line : 3359 E SWISS RD
Second Line :
City : FLAGSTAFF
State : AZ
Zip : 86004-2241
Country : US
Telephone Number : 928-529-0191
Fax Number :
Provider Business Practice Location Address
First Line : 3150 N WINDING BROOK RD
Second Line :
City : FLAGSTAFF
State : AZ
Zip : 86001-0972
Country : US
Telephone Number : 928-774-7106
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 04/25/2007
Last Update Date : 07/08/2007

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Directions to “ JOSELYN STURGIS FENLEY MOTL” Practice Location

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