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NPI Code Detail

MEDICARE: ANNETTE M CANELLA OTR/L

MEDICARE:   ANNETTE M CANELLA  OTR/L
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 Therapist4737AZ

General Provider Information

NPI Number : 1962708099
Entity Type Code : Individual
Provider Name (Legal Business Name) : ANNETTE M CANELLA OTR/L
Provider Business Mailing Address
First Line : 8115 E INDIAN BEND RD
Second Line : STE 123
City : SCOTTSDALE
State : AZ
Zip : 85250-4819
Country : US
Telephone Number : 480-951-6451
Fax Number :
Provider Business Practice Location Address
First Line : 21630 N 19TH AVE STE B3
Second Line :
City : PHOENIX
State : AZ
Zip : 85027-2717
Country : US
Telephone Number : 602-726-2300
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 02/08/2011
Last Update Date : 04/15/2020

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Directions to “ ANNETTE M CANELLA OTR/L” Practice Location

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