Healthcare Provider Details

I. General information

NPI: 1528325719
Provider Name (Legal Business Name): KATHLEEN S MACLUER PA, OT
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 04/12/2012
Last Update Date: 07/13/2020
Certification Date: 07/13/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2 N CENTRAL AVE STE 120
PHOENIX AZ
85004-2972
US

IV. Provider business mailing address

1839 S ALMA SCHOOL RD STE 354
MESA AZ
85210-3028
US

V. Phone/Fax

Practice location:
  • Phone: 602-296-4060
  • Fax: 602-296-4146
Mailing address:
  • Phone: 480-726-2287
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code332B00000X
TaxonomyDurable Medical Equipment & Medical Supplies
License Number7209350001
License Number StateAZ
# 2
Primary TaxonomyN
Taxonomy Code332B00000X
TaxonomyDurable Medical Equipment & Medical Supplies
License Number7057360001
License Number StateAZ
# 3
Primary TaxonomyN
Taxonomy Code332B00000X
TaxonomyDurable Medical Equipment & Medical Supplies
License Number7045160001
License Number StateAZ
# 4
Primary TaxonomyN
Taxonomy Code332B00000X
TaxonomyDurable Medical Equipment & Medical Supplies
License Number7046960001
License Number StateAZ
# 5
Primary TaxonomyN
Taxonomy Code332B00000X
TaxonomyDurable Medical Equipment & Medical Supplies
License Number7041750001
License Number StateAZ
# 6
Primary TaxonomyN
Taxonomy Code332B00000X
TaxonomyDurable Medical Equipment & Medical Supplies
License Number7629170001
License Number StateAZ
# 7
Primary TaxonomyN
Taxonomy Code332B00000X
TaxonomyDurable Medical Equipment & Medical Supplies
License Number7034950001
License Number StateAZ
# 8
Primary TaxonomyY
Taxonomy Code363A00000X
TaxonomyPhysician Assistant
License Number6727
License Number StateAZ
# 9
Primary TaxonomyN
Taxonomy Code225X00000X
TaxonomyOccupational Therapist
License Number6797
License Number StateAZ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: