Healthcare Provider Details

I. General information

NPI: 1376229039
Provider Name (Legal Business Name): TESS CAHIL DAVENPORT OTD
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 06/26/2023
Last Update Date: 10/11/2026
Certification Date: 10/11/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

394 W MAMMOTH CAVE DR
SAN TAN VALLEY AZ
85140-7269
US

IV. Provider business mailing address

394 W MAMMOTH CAVE DR
SAN TAN VALLEY AZ
85140-7269
US

V. Phone/Fax

Practice location:
  • Phone: 480-440-7207
  • Fax:
Mailing address:
  • Phone: 480-440-7207
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225X00000X
TaxonomyOccupational Therapist
License NumberOTH-010479
License Number StateAZ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: