Provider Demographics
NPI:1255841821
Name:YOSHIHARA, ANNA T (OTR/L)
Entity Type:Individual
Prefix:
First Name:ANNA
Middle Name:T
Last Name:YOSHIHARA
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 1:2200 LIBRARY CIR
Mailing Address - Street 2:
Mailing Address - City:GRAND FORKS
Mailing Address - State:ND
Mailing Address - Zip Code:58201-6326
Mailing Address - Country:US
Mailing Address - Phone:701-757-2155
Mailing Address - Fax:701-757-2156
Practice Address - Street 1:1930 E SOUTHERN AVE
Practice Address - Street 2:
Practice Address - City:TEMPE
Practice Address - State:AZ
Practice Address - Zip Code:85282-7518
Practice Address - Country:US
Practice Address - Phone:480-456-0719
Practice Address - Fax:480-456-0163
Is Sole Proprietor?:No
Enumeration Date:2017-10-09
Last Update Date:2020-01-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZOTH-077696225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist