Provider Demographics
NPI:1780865261
Name:LANMAN, ANNETTE YVONNE (COTA)
Entity Type:Individual
Prefix:MRS
First Name:ANNETTE
Middle Name:YVONNE
Last Name:LANMAN
Suffix:
Gender:F
Credentials:COTA
Other - Prefix:MRS
Other - First Name:ANNETTE
Other - Middle Name:YVONNE
Other - Last Name:DORSEY
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:COTA
Mailing Address - Street 1:23819 N 73RD ST
Mailing Address - Street 2:
Mailing Address - City:SCOTTSDALE
Mailing Address - State:AZ
Mailing Address - Zip Code:85255-3499
Mailing Address - Country:US
Mailing Address - Phone:480-419-6690
Mailing Address - Fax:480-659-3721
Practice Address - Street 1:7540 N 19TH AVE
Practice Address - Street 2:
Practice Address - City:PHOENIX
Practice Address - State:AZ
Practice Address - Zip Code:85021-7967
Practice Address - Country:US
Practice Address - Phone:602-324-6500
Practice Address - Fax:602-324-6520
Is Sole Proprietor?:Yes
Enumeration Date:2007-11-26
Last Update Date:2007-11-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ1200224Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes224Z00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapy Assistant