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General NPI Number Information
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NPI Number | 1093566754
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Entity Type | Organization
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Legal Business Name | TUMBLE TOTS ARIZONA
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Dates
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Enumeration Date | 04/01/2024
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Last Update Date | 04/08/2024
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Provider Practice Location Address
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Address Line | 300 E CAMINO DEL PINSAPO
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City | SAHUARITA
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State | AZ
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Zip | 85629-8739
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Country | US
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Telephone | 520-599-3807
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Fax |
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Provider Business Mailing Address
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Address Line | 300 E CAMINO DEL PINSAPO
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City | SAHUARITA
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State | AZ
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Zip | 85629-8739
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Country | US
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Telephone | 520-599-3807
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | CARISSA A CARILLO
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Credential | COTA/L
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Telephone | 520-599-3807
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 225XP0200X
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Taxonomy Name | Pediatric Occupational Therapist
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License Number |
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License Number State |
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