Healthcare Provider Details

I. General information

NPI: 1598676991
Provider Name (Legal Business Name): DIANA ANDREWS OTD, OTR/L
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/15/2026
Last Update Date: 09/15/2026
Certification Date: 09/15/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

370 E VIRGINIA AVE STE 100
PHOENIX AZ
85004-1254
US

IV. Provider business mailing address

7055 N 85TH LN
GLENDALE AZ
85305-6701
US

V. Phone/Fax

Practice location:
  • Phone: 602-258-4788
  • Fax:
Mailing address:
  • Phone: 602-904-9177
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225XH1200X
TaxonomyHand Occupational Therapist
License NumberOTH-010474
License Number StateAZ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: