Healthcare Provider Details

I. General information

NPI: 1720677032
Provider Name (Legal Business Name): PEYTON MICHELE MORRIS OTR/L
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 01/12/2021
Last Update Date: 01/12/2021
Certification Date: 01/10/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3160 N ARIZONA AVE STE 106
CHANDLER AZ
85225-7122
US

IV. Provider business mailing address

3160 N ARIZONA AVE STE 106
CHANDLER AZ
85225-7122
US

V. Phone/Fax

Practice location:
  • Phone: 480-699-4845
  • Fax:
Mailing address:
  • Phone: 480-699-4845
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225XN1300X
TaxonomyNeurorehabilitation Occupational Therapist
License NumberOTH-008340
License Number StateAZ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: