Individual
ANNA DERBAK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
COTA/L
Contact information
Practice address
16455 E AVENUE OF THE FOUNTAINS, FOUNTAIN HILLS, AZ 85268-8307
(480) 816-5805
(480) 816-5807
Mailing address
4434 E CAROL ANN LN, PHOENIX, AZ 85032-4257
(602) 334-6184
Taxonomy
Speciality
Code
Description
License number
State
224Z00000X
Occupational Therapy Assistant
Primary
7412
AZ
Other
Enumeration date
05/07/2018
Last updated
05/07/2018
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