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Individual

RAINA C DASS

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
OTR L

Contact information

Practice address
340 N MT VERNON AVE, PRESCOTT, AZ 86301
(928) 771-2486
(928) 771-9017
Mailing address
12844 E MORENO ST, DEWEY, AZ 86327
(928) 814-2862

Taxonomy

Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
2995
AZ

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
729840
AHCCCS
AZ
Enumeration date
12/05/2006
Last updated
07/08/2007
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