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General NPI Number Information
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NPI Number | 1114142445
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Entity Type | Individual
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Provider Name | CHERYL S NELSON O.T.
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Gender | Female
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Dates
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Enumeration Date | 04/13/2007
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Last Update Date | 05/31/2013
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Provider Practice Location Address
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Address Line | 10450 W MCDOWELL RD STE 102
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City | AVONDALE
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State | AZ
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Zip | 85392-4802
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Country | US
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Telephone | 623-848-4687
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Fax | 623-848-4686
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Provider Business Mailing Address
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Address Line | PO BOX 29870
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City | PHOENIX
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State | AZ
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Zip | 85038-9870
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Country | US
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Telephone | 602-772-3805
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Fax | 602-772-3801
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 225X00000X
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Taxonomy Name | Occupational Therapist
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License Number |
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License Number State |
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