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General NPI Number Information
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NPI Number | 1205757739
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Entity Type | Organization
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Legal Business Name | GENTLE TABLE PEDIATRIC THERAPIES, LLC
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Dates
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Enumeration Date | 07/22/2026
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Last Update Date | 07/22/2026
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Provider Practice Location Address
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Address Line | 19161 W HAZELWOOD ST
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City | LITCHFIELD PARK
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State | AZ
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Zip | 85340-4743
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Country | US
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Telephone | 480-450-0932
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Fax |
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Provider Business Mailing Address
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Address Line | 19161 W HAZELWOOD ST
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City | LITCHFIELD PARK
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State | AZ
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Zip | 85340-4743
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Country | US
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Telephone | 480-450-0932
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Fax |
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Authorized Official
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Title or Position | OWNER, CLINICAL DIRECTOR
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Name | KIMBERLY OCHOA
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Credential | MS, OTR/L
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Telephone | 480-450-0932
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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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