Healthcare Provider Details

I. General information

NPI: 1457655300
Provider Name (Legal Business Name): ESSENTIAL THERAPEUTICS, PLLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/07/2011
Last Update Date: 09/23/2025
Certification Date: 09/23/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5960 E TINTO ST
MESA AZ
85215-0843
US

IV. Provider business mailing address

5960 E TINTO ST
MESA AZ
85215-0843
US

V. Phone/Fax

Practice location:
  • Phone: 480-720-0494
  • Fax:
Mailing address:
  • Phone: 480-720-0494
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code224Z00000X
TaxonomyOccupational Therapy Assistant
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License Number4348
License Number StateAZ
# 3
Primary TaxonomyN
Taxonomy Code225X00000X
TaxonomyOccupational Therapist
License Number
License Number State
# 4
Primary TaxonomyN
Taxonomy Code251C00000X
TaxonomyDevelopmentally Disabled Services Day Training Agency
License Number4348
License Number StateAZ
# 5
Primary TaxonomyN
Taxonomy Code251E00000X
TaxonomyHome Health Agency
License Number4348
License Number StateAZ

VIII. Authorized Official

Name: NICOLETTA DUVALL
Title or Position: OCCUPATIONAL THERAPIST/OWNER
Credential: OTR/L
Phone: 480-720-0494