Healthcare Provider Details

I. General information

NPI: 1164835674
Provider Name (Legal Business Name): ELIZABETH ANN PRINTZ OTR/L
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/03/2014
Last Update Date: 06/03/2014
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6400 LAUREL CANYON BLVD SUITE 560
NORTH HOLLYWOOD CA
91606-1571
US

IV. Provider business mailing address

10993 BLUFFSIDE DR UNIT 2105
STUDIO CITY CA
91604-4449
US

V. Phone/Fax

Practice location:
  • Phone: 818-763-0136
  • Fax: 818-763-3838
Mailing address:
  • Phone: 937-423-5322
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225XP0200X
TaxonomyPediatric Occupational Therapist
License NumberOT 14366
License Number StateCA
# 2
Primary TaxonomyN
Taxonomy Code225XP0019X
TaxonomyPhysical Rehabilitation Occupational Therapist
License NumberOT 14366
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: