Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 225XP0200X | Occupational Therapist - Pediatrics | 0407 | AZ |
NPI | 1033128129 |
---|---|
Provider Name | Ms. Rosanne May Urbanowicz |
First Address | Phoenix, AZ 85028-1932 |
Second Address | Phoenix, AZ 85028-1932 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 06/08/2006 |
Last Update Date | 14/01/2018 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
AZ0445960 | BC/BS AZ (01) | AZ |