Provider Demographics
NPI:1124046925
Name:BURBACH, KARIN SCHNOBRICH (OTRL)
Entity type:Individual
Prefix:MRS
First Name:KARIN
Middle Name:SCHNOBRICH
Last Name:BURBACH
Suffix:
Gender:F
Credentials:OTRL
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8170 33RD AVE S
Mailing Address - Street 2:MAIL STOP 21110Q
Mailing Address - City:MINNEAPOLIS
Mailing Address - State:MN
Mailing Address - Zip Code:55440-1309
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:10250 N 92ND ST
Practice Address - Street 2:STE 112
Practice Address - City:SCOTTSDALE
Practice Address - State:AZ
Practice Address - Zip Code:85258-4510
Practice Address - Country:US
Practice Address - Phone:480-661-7779
Practice Address - Fax:480-661-1546
Is Sole Proprietor?:No
Enumeration Date:2006-07-18
Last Update Date:2016-08-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ3388225XH1200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225XH1200XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistHand
Provider Identifiers
StateIdentifier IDID TypeIssuer
AZ136979Medicaid
AZ1881809499Medicare NSC
AZZ113264Medicare PIN
AZ1396819546Medicare NSC
AZ1164581427Medicare NSC
AZ1871652131Medicare NSC
AZ1447465059Medicare NSC
AZ136979Medicaid
AZ1356556963Medicare NSC
AZ1831211143Medicare NSC
AZ1447465059Medicare NSC