Healthcare Provider Details

I. General information

NPI: 1497253918
Provider Name (Legal Business Name): CYNTHIA SELIM OTR/L
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 01/30/2018
Last Update Date: 06/22/2026
Certification Date: 06/22/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5815 W UTOPIA RD
GLENDALE AZ
85308
US

IV. Provider business mailing address

5815 W UTOPIA ROAD
GLENDALE AZ
85308
US

V. Phone/Fax

Practice location:
  • Phone: 623-537-6000
  • Fax:
Mailing address:
  • Phone: 623-537-6000
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225X00000X
TaxonomyOccupational Therapist
License Number7340
License Number StateAZ
# 2
Primary TaxonomyN
Taxonomy Code225XP0200X
TaxonomyPediatric Occupational Therapist
License Number7340
License Number StateAZ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: