Healthcare Provider Details

I. General information

NPI: 1447310941
Provider Name (Legal Business Name): VICKI LYNN ARENZ OTR L
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

Provider Other Name: VICKI LYNN ARENZ OTR L

II. Dates (important events)

Enumeration Date: 12/12/2006
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3205 S RURAL RD
TEMPE AZ
85282-3853
US

IV. Provider business mailing address

519 E CANTEBRIA DR
GILBERT AZ
85296-3515
US

V. Phone/Fax

Practice location:
  • Phone: 480-730-7100
  • Fax:
Mailing address:
  • Phone: 480-892-9781
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225X00000X
TaxonomyOccupational Therapist
License Number1035
License Number StateAZ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: