MEDICARE: BRENDA HUBBELL MS, OTR/L, CEES

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
1	225X00000X	Occupational Therapist	2476	AZ
2	225XE0001X	Environmental Modification Occupational Therapist	2476	AZ
3	225XE1200X	Ergonomics Occupational Therapist	2476	AZ
4	225XH1300X	Human Factors Occupational Therapist	2476	AZ
5	225XP0019X	Physical Rehabilitation Occupational Therapist	2476	AZ

General Provider Information

NPI Number	:	1700764693
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	BRENDA HUBBELL MS, OTR/L, CEES

Provider Business Mailing Address
First Line	:	PO BOX 11076
Second Line	:
City	:	TEMPE
State	:	AZ
Zip	:	85284-0018
Country	:	US
Telephone Number	:	602-750-6778
Fax Number	:	480-820-5958

Provider Business Practice Location Address
First Line	:	6448 S MCCLINTOCK DR
Second Line	:
City	:	TEMPE
State	:	AZ
Zip	:	85283-3982
Country	:	US
Telephone Number	:	602-750-6778
Fax Number	:	480-820-5958

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	08/26/2025
Last Update Date	:	08/26/2025

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