Provider Demographics
NPI:1447587738
Name:TAGSIP, MAUREEN ANCAJAS (OTR/L)
Entity Type:Individual
Prefix:
First Name:MAUREEN
Middle Name:ANCAJAS
Last Name:TAGSIP
Suffix:
Gender:F
Credentials:OTR/L
Other - Prefix:
Other - First Name:MAUREEN
Other - Middle Name:ANCAJAS
Other - Last Name:TAGSIP
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:MD
Mailing Address - Street 1:1333 W GUADALUPE RD APT 617
Mailing Address - Street 2:
Mailing Address - City:GILBERT
Mailing Address - State:AZ
Mailing Address - Zip Code:85233-3016
Mailing Address - Country:US
Mailing Address - Phone:732-403-9448
Mailing Address - Fax:
Practice Address - Street 1:23005 N 74TH ST
Practice Address - Street 2:
Practice Address - City:SCOTTSDALE
Practice Address - State:AZ
Practice Address - Zip Code:85255-7500
Practice Address - Country:US
Practice Address - Phone:888-842-3780
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2009-11-08
Last Update Date:2023-11-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NM2608225X00000X
TX113326225X00000X
MO2009029855225X00000X
NJ46TR00519200225X00000X
AZOTH-009417225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist