Provider Demographics
NPI:1073843884
Name:MARANO, TAMARA SUE (OTR/L)
Entity Type:Individual
Prefix:
First Name:TAMARA
Middle Name:SUE
Last Name:MARANO
Suffix:
Gender:F
Credentials:OTR/L
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6681 W MEGAN ST
Mailing Address - Street 2:
Mailing Address - City:CHANDLER
Mailing Address - State:AZ
Mailing Address - Zip Code:85226-1666
Mailing Address - Country:US
Mailing Address - Phone:480-626-4643
Mailing Address - Fax:
Practice Address - Street 1:114 W THOMAS RD
Practice Address - Street 2:
Practice Address - City:PHOENIX
Practice Address - State:AZ
Practice Address - Zip Code:85013-4405
Practice Address - Country:US
Practice Address - Phone:602-406-3230
Practice Address - Fax:602-406-4105
Is Sole Proprietor?:No
Enumeration Date:2009-12-30
Last Update Date:2009-12-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ4182225X00000X
IL056.005260225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist