Provider Demographics
NPI:1255383196
Name:MIKLOS, RACHAEL E (COTA)
Entity type:Individual
Prefix:
First Name:RACHAEL
Middle Name:E
Last Name:MIKLOS
Suffix:
Gender:F
Credentials:COTA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1054 N 91ST PL
Mailing Address - Street 2:
Mailing Address - City:MESA
Mailing Address - State:AZ
Mailing Address - Zip Code:85207-5128
Mailing Address - Country:US
Mailing Address - Phone:480-600-4667
Mailing Address - Fax:602-528-3439
Practice Address - Street 1:455 N 3RD ST STE 200
Practice Address - Street 2:
Practice Address - City:PHOENIX
Practice Address - State:AZ
Practice Address - Zip Code:85004-3932
Practice Address - Country:US
Practice Address - Phone:602-528-3450
Practice Address - Fax:602-528-3439
Is Sole Proprietor?:No
Enumeration Date:2006-05-17
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
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Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes224Z00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapy Assistant