Provider Demographics
NPI:1497175764
Name:COWAN, RAE P (OT)
Entity Type:Individual
Prefix:
First Name:RAE
Middle Name:P
Last Name:COWAN
Suffix:
Gender:F
Credentials:OT
Other - Prefix:
Other - First Name:RAE
Other - Middle Name:P
Other - Last Name:AARONSON
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:PO BOX 80217
Mailing Address - Street 2:
Mailing Address - City:PHOENIX
Mailing Address - State:AZ
Mailing Address - Zip Code:85060-0217
Mailing Address - Country:US
Mailing Address - Phone:602-385-2115
Mailing Address - Fax:480-418-3323
Practice Address - Street 1:525 S CHANDLER VILLAGE DR
Practice Address - Street 2:
Practice Address - City:CHANDLER
Practice Address - State:AZ
Practice Address - Zip Code:85226-5069
Practice Address - Country:US
Practice Address - Phone:480-750-0323
Practice Address - Fax:480-786-5832
Is Sole Proprietor?:No
Enumeration Date:2014-04-24
Last Update Date:2022-09-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ46TR00648800225X00000X
AZOTH-007653225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist