MEDICARE: NICOLE D KUTCH OTR/L, CHT

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	Z12164	LA
2	225XH1200X	Hand Occupational Therapist	Z12164	LA
3	225XH1200X	Hand Occupational Therapist	720	ND
4	225X00000X	Occupational Therapist	8140	AZ

General Provider Information

NPI Number	:	1972684603
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	NICOLE D KUTCH OTR/L, CHT

Provider Business Mailing Address
First Line	:	300 W CLARENDON AVE STE 285
Second Line	:
City	:	PHOENIX
State	:	AZ
Zip	:	85013-3474
Country	:	US
Telephone Number	:	602-279-6905
Fax Number	:	602-279-6934

Provider Business Practice Location Address
First Line	:	300 W CLARENDON AVE STE 285
Second Line	:
City	:	PHOENIX
State	:	AZ
Zip	:	85013-3474
Country	:	US
Telephone Number	:	602-279-6905
Fax Number	:	602-279-6934

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

Provider Enumeration Date	:	10/18/2006
Last Update Date	:	08/24/2020

Similar Medicare Providers

1255470902 — CARRIE FANCHER OT
Practice Location Address:

300 W CLARENDON AVE STE 285
PHOENIX, AZ
85013-3474

Practice Phone: 602-279-6905
Practice Fax: 602-279-6934

1093127797 — KAYLA ANN V YU OTD, OTR/L
Practice Location Address:

300 W CLARENDON AVE STE 285
PHOENIX, AZ
85013-3474

Practice Phone: 602-279-6905
Practice Fax: 602-279-6934

1114640406 — SHELBY ELIZABETH JOHNSON PT, DPT
Practice Location Address:

300 W CLARENDON AVE STE 285
PHOENIX, AZ
85013-3474

Practice Phone: 602-277-3686
Practice Fax: 602-279-6934

1962126888 — MIA CATHERINE GRAHAM OT, DOT
Practice Location Address:

300 W CLARENDON AVE STE 285
PHOENIX, AZ
85013-3474

Practice Phone: 602-277-3686
Practice Fax: 602-279-6934

1356204564 — LINDSAY KEARNS MA, LAC
Practice Location Address:

4545 N 36TH ST STE 217
PHOENIX, AZ
85018-3474

Practice Phone: 602-332-5737
Practice Fax:

1316986797 — ALBERTSONS LLC
Practice Location Address:

1849 W GREENWAY RD
PHOENIX, AZ
85023-3474

Practice Phone: 602-866-0647
Practice Fax: 602-866-0674

Directions to “ NICOLE D KUTCH OTR/L, CHT” Practice Location

Language	Start Address	Practice Location

These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

Copyright © 2007-2025 (Powered by Swiss Vault Engine), all rights reserved. HIPAA liability, trademark, document use and software licensing rules apply. All registered trademarks, used in the content, are the property of their owners. Your interactions with this site are in accordance with our Terms of Use and Privacy Policy.