Mary Elizabeth Bastian
Student in an Organized Health Care Education/Training Program in Tempe, AZ. Individual provider (NPI-1).
NPI number1396351805
StatusActive
Last updated in NPPESSep 20, 2020
Details
- NPI
- 1396351805
- Entity type
- Individual (NPI-1)
- Name
- Mary Elizabeth Bastian
- Sex
- Female
- Sole proprietor
- No
- Enumeration date
- Sep 20, 2020
- Certification date
- Sep 20, 2020
- Last updated
- Sep 20, 2020
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 390200000X | Student in an Organized Health Care Education/Training Program | – | – | Yes |
| 2255A2300X | Specialist/Technologist, Athletic Trainer | – | – |
Practice location
1730 S Mill AveTempe, AZ 85281-6600
Phone 480-967-1661
Mailing address
4950 E Van Buren St Apt 372Phoenix, AZ 85008-7054
Phone 585-743-0508
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