Healthcare Provider Details

I. General information

NPI: 1144955535
Provider Name (Legal Business Name): CYNTHIA E CANTU OTR
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/19/2022
Last Update Date: 08/25/2026
Certification Date: 08/25/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2013 N 36TH ST
PHOENIX AZ
85008-3026
US

IV. Provider business mailing address

2702 E FLOWER ST
PHOENIX AZ
85016-7498
US

V. Phone/Fax

Practice location:
  • Phone: 602-381-6100
  • Fax:
Mailing address:
  • Phone: 602-381-6080
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225X00000X
TaxonomyOccupational Therapist
License Number009998
License Number StateAZ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: