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NPI Code Detail

MEDICARE: NATALIE BLACK MOT

MEDICARE: NATALIE BLACK MOT
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1225X00000XOccupational TherapistL-007693AZ

General Provider Information

NPI Number : 1194299560
Entity Type Code : Individual
Provider Name (Legal Business Name) : NATALIE BLACK MOT
Provider Business Mailing Address
First Line : 14287 N 87TH ST STE 220
Second Line :
City : SCOTTSDALE
State : AZ
Zip : 85260-3698
Country : US
Telephone Number : 602-329-8250
Fax Number : 480-565-1898
Provider Business Practice Location Address
First Line : 2122 E HIGHLAND AVE STE 200
Second Line :
City : PHOENIX
State : AZ
Zip : 85016-4777
Country : US
Telephone Number : 602-778-0900
Fax Number : 602-778-6606
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 01/17/2019
Last Update Date : 02/22/2022

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