Provider Demographics
NPI:1942559281
Name:HERMAN, ANGELA SACHIKO (MA OTR/L)
Entity Type:Individual
Prefix:MS
First Name:ANGELA
Middle Name:SACHIKO
Last Name:HERMAN
Suffix:
Gender:F
Credentials:MA OTR/L
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5625 N 45TH ST
Mailing Address - Street 2:
Mailing Address - City:PHOENIX
Mailing Address - State:AZ
Mailing Address - Zip Code:85018-1272
Mailing Address - Country:US
Mailing Address - Phone:602-410-5461
Mailing Address - Fax:
Practice Address - Street 1:9821 E BELL RD
Practice Address - Street 2:
Practice Address - City:SCOTTSDALE
Practice Address - State:AZ
Practice Address - Zip Code:85260-2344
Practice Address - Country:US
Practice Address - Phone:602-410-5461
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-08-31
Last Update Date:2012-08-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ5213225XP0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225XP0200XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistPediatrics