Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 225X00000X | Occupational Therapist | 0395 | AZ |
N | 225XH1200X | Occupational Therapist - Hand | 0395 | AZ |
NPI | 1053314567 |
---|---|
Provider Name | Ms. Karen Ann Thomas |
First Address | Scottsdale, AZ 85258-1217 |
Second Address | Scottsdale, AZ 85258-1217 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 30/05/2005 |
Last Update Date | 09/07/2007 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
R10769 | (02) | AZ |