Provider Demographics
NPI:1013096478
Name:MASCARI, ALLISON MARIE (MS, OTR L)
Entity Type:Individual
Prefix:
First Name:ALLISON
Middle Name:MARIE
Last Name:MASCARI
Suffix:
Gender:F
Credentials:MS, OTR L
Other - Prefix:
Other - First Name:ALLISON
Other - Middle Name:MARIE
Other - Last Name:BLECHACZ
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MS, OTR L
Mailing Address - Street 1:6115 W LAREDO ST
Mailing Address - Street 2:
Mailing Address - City:CHANDLER
Mailing Address - State:AZ
Mailing Address - Zip Code:85226-1716
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:8409 S AVENIDA DEL YAQUI
Practice Address - Street 2:
Practice Address - City:GUADALUPE
Practice Address - State:AZ
Practice Address - Zip Code:85283-1027
Practice Address - Country:US
Practice Address - Phone:480-897-6202
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-11-03
Last Update Date:2007-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ3002225XP0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225XP0200XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistPediatrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
AZ821282Medicaid