Provider Demographics
NPI:1528259116
Name:REDMAN, GLORIA (COTA)
Entity type:Individual
Prefix:MRS
First Name:GLORIA
Middle Name:
Last Name:REDMAN
Suffix:
Gender:F
Credentials:COTA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2921 S MARVIN AVE
Mailing Address - Street 2:
Mailing Address - City:TUCSON
Mailing Address - State:AZ
Mailing Address - Zip Code:85730-1754
Mailing Address - Country:US
Mailing Address - Phone:520-909-1860
Mailing Address - Fax:520-790-4472
Practice Address - Street 1:2921 S MARVIN AVE
Practice Address - Street 2:
Practice Address - City:TUCSON
Practice Address - State:AZ
Practice Address - Zip Code:85730-1754
Practice Address - Country:US
Practice Address - Phone:520-909-1860
Practice Address - Fax:520-790-4472
Is Sole Proprietor?:Yes
Enumeration Date:2007-08-07
Last Update Date:2007-08-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ1899224Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes224Z00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapy Assistant