Healthcare Provider Details

I. General information

NPI: 1467063933
Provider Name (Legal Business Name): NAOMI ANN ENGELS OTD, OTR/L
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: NAOMI ANN BARNHART

II. Dates (important events)

Enumeration Date: 08/10/2020
Last Update Date: 08/12/2020
Certification Date: 08/12/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6315 W PORT AU PRINCE LN
GLENDALE AZ
85306-3217
US

IV. Provider business mailing address

4441 N 123RD DR
AVONDALE AZ
85392-6790
US

V. Phone/Fax

Practice location:
  • Phone: 623-412-4550
  • Fax:
Mailing address:
  • Phone: 623-498-0076
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225X00000X
TaxonomyOccupational Therapist
License NumberOTH-008182
License Number StateAZ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: