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Individual

MS. DEBORAH LYNN KOOIMAN

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
OTR/L

Contact information

Practice address
413 E. TREMAINE AV, GILBERT, AZ 85234-4623
(602) 295-5040
Mailing address
19802 N 47TH LN, GLENDALE, AZ 85308-5167
(832) 495-9266

Taxonomy

Speciality
Code
Description
License number
State
225XG0600X
Gerontology Occupational Therapist
Primary
4980
AZ

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
4980
OCCUPATIONAL THERAPY LICENSE
AZ
Enumeration date
02/10/2012
Last updated
02/10/2012
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