Individual
ALYSSA ROSE BAUMAN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MS, OTR/L
Contact information
Practice address
21630 N 19TH AVE STE B3, PHOENIX, AZ 85027-2717
(248) 894-7815
Mailing address
392 W CAROB DR, CHANDLER, AZ 85248-4518
(248) 894-7815
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
OTH-007713
BOARD OF OCCUPATIONAL THERAPY EXAMINERS
—
Enumeration date
07/31/2019
Last updated
07/31/2019
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