Provider Demographics
NPI:1215168943
Name:DAUSEND, BARBARAANN F (OT)
Entity type:Individual
Prefix:
First Name:BARBARAANN
Middle Name:F
Last Name:DAUSEND
Suffix:
Gender:F
Credentials:OT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:22983 N 104TH AVE
Mailing Address - Street 2:
Mailing Address - City:PEORIA
Mailing Address - State:AZ
Mailing Address - Zip Code:85383-2764
Mailing Address - Country:US
Mailing Address - Phone:602-402-2636
Mailing Address - Fax:602-603-5775
Practice Address - Street 1:22983 N 104TH AVE
Practice Address - Street 2:
Practice Address - City:PEORIA
Practice Address - State:AZ
Practice Address - Zip Code:85383-2764
Practice Address - Country:US
Practice Address - Phone:602-402-2636
Practice Address - Fax:602-603-5775
Is Sole Proprietor?:Yes
Enumeration Date:2009-07-29
Last Update Date:2019-10-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZOTH-003890225XM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225XM0800XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistMental Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
AZ446793Medicaid