Provider Demographics
NPI:1568524239
Name:MAYRSOHN, VALERIE A (O T)
Entity Type:Individual
Prefix:
First Name:VALERIE
Middle Name:A
Last Name:MAYRSOHN
Suffix:
Gender:F
Credentials:O T
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3257 N GLEN CREEK DR
Mailing Address - Street 2:
Mailing Address - City:TUCSON
Mailing Address - State:AZ
Mailing Address - Zip Code:85712-1138
Mailing Address - Country:US
Mailing Address - Phone:520-360-9591
Mailing Address - Fax:
Practice Address - Street 1:2919 E GRANT RD
Practice Address - Street 2:
Practice Address - City:TUCSON
Practice Address - State:AZ
Practice Address - Zip Code:85716-2717
Practice Address - Country:US
Practice Address - Phone:520-326-2782
Practice Address - Fax:520-296-3552
Is Sole Proprietor?:Yes
Enumeration Date:2006-12-15
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ2101225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
AZ2101OtherSTATE LICENSE