Individual
SAM MEHRDAD RASANANI
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
OTD
Contact information
Practice address
6635 W HAPPY VALLEY RD STE A104-218, GLENDALE, AZ 85310-2609
(623) 224-1214
Mailing address
4724 E GATEWOOD RD, PHOENIX, AZ 85050-6154
(267) 285-6534
Taxonomy
Speciality
Code
Description
License number
State
225XP0200X
Pediatric Occupational Therapist
Primary
OTH-008668
AZ
Other
Enumeration date
02/16/2022
Last updated
02/16/2022
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