Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 225XP0200X | Occupational Therapist - Pediatrics | 3002 | AZ |
NPI | 1013096478 |
---|---|
Provider Name | Allison Marie Mascari |
First Address | Chandler, AZ 85226-1716 |
Second Address | Guadalupe, AZ 85283-1027 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 03/11/2006 |
Last Update Date | 09/07/2007 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
821282 | (05) | AZ |