=====================================================
General NPI Number Information
=====================================================
NPI Number | 1164843405
-----------------------------------------------------
Entity Type | Individual
-----------------------------------------------------
Provider Name | JOYCE KAMINSKI OTR/L
-----------------------------------------------------
Gender | Female
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 01/03/2014
-----------------------------------------------------
Last Update Date | 01/03/2014
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 1400 E SOUTHERN AVE SUITE 310
-----------------------------------------------------
City | TEMPE
-----------------------------------------------------
State | AZ
-----------------------------------------------------
Zip | 85282-5691
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 866-308-2700
-----------------------------------------------------
Fax | 888-438-0350
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 1400 E SOUTHERN AVE SUITE 310
-----------------------------------------------------
City | TEMPE
-----------------------------------------------------
State | AZ
-----------------------------------------------------
Zip | 85282-5691
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 866-308-2700
-----------------------------------------------------
Fax | 888-438-0350
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position |
-----------------------------------------------------
Name |
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone |
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 174400000X
-----------------------------------------------------
Taxonomy Name | Specialist
-----------------------------------------------------
License Number | OC005557L
-----------------------------------------------------
License Number State | PA
-----------------------------------------------------