Dynamic Function Therapy Services, PLLC

Primary specialty

Occupational TherapistTaxonomy code 225X00000X

License

4587 Issued in AZ

Legal business name

DYNAMIC FUNCTION THERAPY SERVICES, PLLC

Practice address

3140 E Fox St
Mesa, AZ 85213-5418

Phone

(605) 490-1554

Fax

(480) 634-6442

NPI assigned

Jul 9, 2012

Last updated

Jul 9, 2012By the provider in NPPES

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Michelle T Vaughan, O.T.L.

Title

Owner

Phone

(605) 490-1554

Specialties & licenses 1

Addresses

Other identifiers 1

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Michelle Jensen, OT

  • Occupational Therapist
  • Mesa, AZ
  • NPI 1740329887
  NPD (past)

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1341792000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1341792000000",
    "number": "1073878807",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3140 E FOX ST",
            "city": "MESA",
            "state": "AZ",
            "postal_code": "852135418",
            "telephone_number": "605-490-1554",
            "fax_number": "480-634-6442"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3140 E FOX ST",
            "city": "MESA",
            "state": "AZ",
            "postal_code": "852135418",
            "telephone_number": "605-490-1554",
            "fax_number": "480-634-6442"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DYNAMIC FUNCTION THERAPY SERVICES, PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-07-09",
        "last_updated": "2012-07-09",
        "status": "A",
        "authorized_official_last_name": "VAUGHAN",
        "authorized_official_first_name": "MICHELLE",
        "authorized_official_middle_name": "T",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "605-490-1554",
        "authorized_official_credential": "O.T.L."
    },
    "taxonomies": [
        {
            "code": "225X00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist",
            "state": "AZ",
            "license": "4587",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "INDIVIDUAL NPI #",
            "identifier": "1740329887",
            "state": "AZ"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• DW Counseling Center, LLC (Desert Winds Counseling)
• Robert Dykhuizen, D.C.
• Denell Dykstra, OT
• Dynamic Dental Health Associates of Arizona (Red Mountain Family Dental)
• Dynamic Dental Health Associates of Arizona (Sossaman Family Dental)
• Dynamic Living Counseling Inc
• Dynamis Counseling LLC
• John Dyorich
• Lindi L Dyson, LCSW
• E. Mark Wade Ddspc (family care dentistry)

• Occupational Therapist in Mesa, AZ
• Providers in Mesa, AZ by specialty
• Occupational Therapist in Arizona

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 9, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.