Individual
GWEN MARIE KOOI
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
OTR
Contact information
Practice address
1010 E 10TH ST, TUCSON, AZ 85719-5813
(520) 225-6410
Mailing address
8342 E SANDSTONE DR, TUCSON, AZ 85750-9783
(520) 749-2052
Taxonomy
Speciality
Code
Description
License number
State
225XP0200X
Pediatric Occupational Therapist
Primary
215
AZ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
068204
—
AZ
Enumeration date
04/02/2007
Last updated
07/08/2007
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