Healthcare Provider Details

I. General information

NPI: 1255243580
Provider Name (Legal Business Name): KOA PEDIATRIC THERAPY
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/21/2026
Last Update Date: 09/21/2026
Certification Date: 09/21/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

14300 N NORTHSIGHT BLVD STE 103
SCOTTSDALE AZ
85260-3673
US

IV. Provider business mailing address

5121 E DANBURY RD
SCOTTSDALE AZ
85254-7677
US

V. Phone/Fax

Practice location:
  • Phone: 602-730-5111
  • Fax:
Mailing address:
  • Phone: 602-730-5111
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225X00000X
TaxonomyOccupational Therapist
License Number
License Number State

VIII. Authorized Official

Name: LINDSEY SANDYS
Title or Position: OWNER
Credential: OTD, OTR/L
Phone: 602-730-5111