Healthcare Provider Details

I. General information

NPI: 1538992904
Provider Name (Legal Business Name): MICAELA HUHN OTD, OTR/L
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 08/21/2024
Last Update Date: 09/21/2026
Certification Date: 09/21/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3530 S VAL VISTA DR STE A211
GILBERT AZ
85297-7318
US

IV. Provider business mailing address

3530 S VAL VISTA DR STE A211
GILBERT AZ
85297-7318
US

V. Phone/Fax

Practice location:
  • Phone: 562-652-7328
  • Fax:
Mailing address:
  • Phone: 562-652-7328
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225X00000X
TaxonomyOccupational Therapist
License NumberOTH-009722
License Number StateAZ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: