Individual
IRENE IMANI KWANGABA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
OTD
Contact information
Practice address
3700 N 24TH ST STE 130, PHOENIX, AZ 85016-6535
(602) 903-4072
(866) 877-7902
Mailing address
1001 W 17TH ST, TEMPE, AZ 85281-6415
(760) 412-9862
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
—
—
225XP0200X
Pediatric Occupational Therapist
Primary
—
—
Other
Enumeration date
07/31/2024
Last updated
07/31/2024
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