Healthcare Provider Details

I. General information

NPI: 1689891244
Provider Name (Legal Business Name): OCCUPATIONAL DIAGNOSTICS, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/18/2007
Last Update Date: 09/11/2025
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2055 E SOUTHERN AVE SUITE C
TEMPE AZ
85282-7507
US

IV. Provider business mailing address

2055 E SOUTHERN AVE SUITE C
TEMPE AZ
85282-7507
US

V. Phone/Fax

Practice location:
  • Phone: 480-820-5526
  • Fax: 480-820-0136
Mailing address:
  • Phone: 480-820-5526
  • Fax: 480-820-0136

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code225X00000X
TaxonomyOccupational Therapist
License Number0090
License Number StateAZ
# 2
Primary TaxonomyN
Taxonomy Code225XE1200X
TaxonomyErgonomics Occupational Therapist
License Number0090
License Number StateAZ
# 3
Primary TaxonomyN
Taxonomy Code225XH1200X
TaxonomyHand Occupational Therapist
License Number0090
License Number StateAZ
# 4
Primary TaxonomyN
Taxonomy Code225XH1300X
TaxonomyHuman Factors Occupational Therapist
License Number0090
License Number StateAZ
# 5
Primary TaxonomyY
Taxonomy Code225XN1300X
TaxonomyNeurorehabilitation Occupational Therapist
License Number0090
License Number StateAZ

VIII. Authorized Official

Name: NANCY M. CONRAD
Title or Position: OWNER, PRESIDENT
Credential: OTRL, CDMS
Phone: 480-820-5526