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General NPI Number Information
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NPI Number | 1538667738
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Entity Type | Individual
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Provider Name | MARY MARGARET PINELO OTD, OTR/L, CLT-LANA
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Gender | Female
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Dates
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Enumeration Date | 01/23/2018
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Last Update Date | 01/23/2018
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Provider Practice Location Address
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Address Line | 5605 W EUGIE AVE STE 212
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City | GLENDALE
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State | AZ
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Zip | 85304-1275
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Country | US
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Telephone | 602-865-2538
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Fax |
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Provider Business Mailing Address
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Address Line | 7045 N 7TH ST APT 170
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City | PHOENIX
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State | AZ
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Zip | 85020-5341
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Country | US
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Telephone | 402-830-9448
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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 | 6642
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License Number State | AZ
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