Provider Demographics
NPI:1053545491
Name:BEANE, ELIZABETH M (OT)
Entity type:Individual
Prefix:
First Name:ELIZABETH
Middle Name:M
Last Name:BEANE
Suffix:
Gender:F
Credentials:OT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:18343 W SAGUARO LN
Mailing Address - Street 2:
Mailing Address - City:SURPRISE
Mailing Address - State:AZ
Mailing Address - Zip Code:85388-2369
Mailing Address - Country:US
Mailing Address - Phone:206-718-9671
Mailing Address - Fax:
Practice Address - Street 1:18343 W SAGUARO LN
Practice Address - Street 2:
Practice Address - City:SURPRISE
Practice Address - State:AZ
Practice Address - Zip Code:85388-2369
Practice Address - Country:US
Practice Address - Phone:206-718-9671
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2009-05-13
Last Update Date:2023-12-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAOT00001835225X00000X
AZ007066225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist