Healthcare Provider Details

I. General information

NPI: 1598692469
Provider Name (Legal Business Name): ARIANA PETERSON
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 05/06/2026
Last Update Date: 05/06/2026
Certification Date: 05/05/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

15333 N PIMA RD STE 305
SCOTTSDALE AZ
85260-2717
US

IV. Provider business mailing address

29856 W CLARENDON AVE
BUCKEYE AZ
85396-7177
US

V. Phone/Fax

Practice location:
  • Phone: 602-688-2824
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225XP0200X
TaxonomyPediatric Occupational Therapist
License NumberOTA-050039
License Number StateAZ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: