Siyanda Obed Mquqwana, OT
Individual provider Active NPI Occupational Therapist · San Luis, AZ
NPI 1164557724 · NPPES record last updated Jul 8, 2007
Key facts
- NPI
- 1164557724
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Occupational Therapist 225X00000X
- License
- 2855 (AZ)
- Practice address
- 1453 N Main Street
Suite F
San Luis, AZ 85349 - Phone
- (928) 627-6567
- NPI assigned
- Feb 23, 2007
- Sex
- Male
- Sole proprietor
- Yes
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Occupational Therapist | 225X00000X | 2855 | AZ | Yes |
Addresses
Primary practice location
1453 N Main Street
Suite F
San Luis, AZ 85349
Mailing address
1215 W 13TH PL
Yuma, AZ 85364-4480
Phone (928) 317-0128
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 719643 | Other | AZ | AHCCCS PROVIDER ID |
Other providers in San Luis, AZ
- Diana Lorena Monroy
- Monica Montufar
- Rosario Alejandra Morales Villegas
- Agustin Morales
- Larry Anthony Morales
- Clarisse Vanessa Ngueha-Nana
- Armik Ohanesyan Salmas
- Alejandro Olea
- Maricela Sevilla Olea
- Angeles Olivarez
All providers in San Luis, AZ · Occupational Therapist in Arizona
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jul 8, 2007. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.