Healthcare Provider Details

I. General information

NPI: 1700586310
Provider Name (Legal Business Name): CHRISTIE VRANKOVIC
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 03/03/2023
Last Update Date: 03/03/2023
Certification Date: 03/03/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4350 E RAY RD
PHOENIX AZ
85044-4703
US

IV. Provider business mailing address

5010 E CHEYENNE DR APT 1094
PHOENIX AZ
85044-1783
US

V. Phone/Fax

Practice location:
  • Phone: 480-704-5954
  • Fax:
Mailing address:
  • Phone: 718-926-3680
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225X00000X
TaxonomyOccupational Therapist
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: