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General NPI Number Information
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NPI Number | 1427916105
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Entity Type | Individual
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Provider Name | AEDAN COLLINS OTR/L, OTD
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Gender | Male
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Dates
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Enumeration Date | 01/12/2026
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Last Update Date | 01/12/2026
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Provider Practice Location Address
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Address Line | 1617 S 67TH AVE
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City | PHOENIX
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State | AZ
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Zip | 85043-7717
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Country | US
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Telephone | 623-707-4500
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Fax |
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Provider Business Mailing Address
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Address Line | 3700 E WILLIAMS FIELD RD APT 1059
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City | GILBERT
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State | AZ
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Zip | 85295-2000
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Country | US
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Telephone | 269-944-6421
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Fax |
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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 | OTH-009731
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License Number State | AZ
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