Provider Demographics
NPI:1922188465
Name:SOBEL, AUDREY JOAN (RPT)
Entity Type:Individual
Prefix:
First Name:AUDREY
Middle Name:JOAN
Last Name:SOBEL
Suffix:
Gender:F
Credentials:RPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4550 E. BELL ROAD
Mailing Address - Street 2:#114
Mailing Address - City:PHOENIX
Mailing Address - State:AZ
Mailing Address - Zip Code:85032-9342
Mailing Address - Country:US
Mailing Address - Phone:602-996-6668
Mailing Address - Fax:602-494-0926
Practice Address - Street 1:4550 E. BELL ROAD
Practice Address - Street 2:SUITE 114
Practice Address - City:PHOENIX
Practice Address - State:AZ
Practice Address - Zip Code:85032-9342
Practice Address - Country:US
Practice Address - Phone:602-996-6668
Practice Address - Fax:602-494-0926
Is Sole Proprietor?:No
Enumeration Date:2006-10-17
Last Update Date:2007-09-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ0936225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist