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General NPI Number Information
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NPI Number | 1841104411
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Entity Type | Organization
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Legal Business Name | RAISE 'EM UO LLC
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Dates
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Enumeration Date | 09/30/2026
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Last Update Date | 09/30/2026
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Provider Practice Location Address
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Address Line | 2704 E FAIRMOUNT AVE
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City | PHOENIX
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State | AZ
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Zip | 85016-6814
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Country | US
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Telephone | 602-301-4760
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Fax |
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Provider Business Mailing Address
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Address Line | 2704 E FAIRMOUNT AVE
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City | PHOENIX
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State | AZ
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Zip | 85016-6814
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | LINDA NICCOLE SWIM
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Credential | COTA/L
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Telephone | 602-301-4760
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 225XP0200X
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Taxonomy Name | Pediatric Occupational Therapist
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License Number |
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License Number State | NULL
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