Provider Demographics
NPI:1851924831
Name:PASQUINELLI, ANNA LOUISE (COTA)
Entity Type:Individual
Prefix:
First Name:ANNA
Middle Name:LOUISE
Last Name:PASQUINELLI
Suffix:
Gender:F
Credentials:COTA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3449 E OREGON AVE
Mailing Address - Street 2:
Mailing Address - City:PHOENIX
Mailing Address - State:AZ
Mailing Address - Zip Code:85018-1527
Mailing Address - Country:US
Mailing Address - Phone:623-238-8876
Mailing Address - Fax:
Practice Address - Street 1:19670 E REINS RD
Practice Address - Street 2:
Practice Address - City:QUEEN CREEK
Practice Address - State:AZ
Practice Address - Zip Code:85142-8681
Practice Address - Country:US
Practice Address - Phone:480-528-2746
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-02-18
Last Update Date:2020-02-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ005936226000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes226000000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersRecreational Therapist Assistant