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NPI Code Detail

MEDICARE: ADASIAH CARLSON

MEDICARE: ADASIAH CARLSON
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 TherapistOTH-008876AZ
2225XP0200XPediatric Occupational Therapist

General Provider Information

NPI Number : 1316671266
Entity Type Code : Individual
Provider Name (Legal Business Name) : ADASIAH CARLSON
Provider Business Mailing Address
First Line : 13744 W KEIM DR
Second Line :
City : LITCHFIELD PARK
State : AZ
Zip : 85340-5340
Country : US
Telephone Number : 716-489-0904
Fax Number :
Provider Business Practice Location Address
First Line : 17100 E SHEA BLVD STE 600
Second Line :
City : FOUNTAIN HILLS
State : AZ
Zip : 85268-6663
Country : US
Telephone Number : 480-837-4565
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 07/14/2022
Last Update Date : 03/09/2026

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Directions to “ ADASIAH CARLSON ” Practice Location

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