MEDICARE: HOLLY HUSSEY 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
1	225X00000X	Occupational Therapist	5659	AZ

General Provider Information

NPI Number	:	1750702759
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	HOLLY HUSSEY 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	:	480-937-1000
Fax Number	:	480-860-0356

Provider Business Practice Location Address
First Line	:	26900 N LAKE PLEASANT PKWY STE 120
Second Line	:
City	:	PEORIA
State	:	AZ
Zip	:	85383-1590
Country	:	US
Telephone Number	:	623-400-9100
Fax Number	:	623-400-9101

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

Provider Enumeration Date	:	12/18/2013
Last Update Date	:	06/11/2026

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Directions to “ HOLLY HUSSEY MOT” Practice Location

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