Healthcare Provider Details

I. General information

NPI: 1922008515
Provider Name (Legal Business Name): DIANE APRIL BOWLUS OT/L
Entity Type: Individual
Gender: Female
Sole Proprietor: X

Provider Other Name: CENTRAL ARIZONA THERAPY LLC

II. Dates (important events)

Enumeration Date: 07/26/2005
Last Update Date: 09/11/2025
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

513 AZURE DR
CAMP VERDE AZ
86322-7276
US

IV. Provider business mailing address

PO BOX 640
CAMP VERDE AZ
86322-0640
US

V. Phone/Fax

Practice location:
  • Phone: 928-567-7330
  • Fax: 928-567-4146
Mailing address:
  • Phone: 928-567-7330
  • Fax: 928-567-4146

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code225X00000X
TaxonomyOccupational Therapist
License Number1785
License Number StateAZ
# 2
Primary TaxonomyN
Taxonomy Code225XH1300X
TaxonomyHuman Factors Occupational Therapist
License Number1785
License Number StateAZ
# 3
Primary TaxonomyY
Taxonomy Code225XP0200X
TaxonomyPediatric Occupational Therapist
License Number1785
License Number StateAZ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: