Karli Banks, OTRL

Individual provider Active NPI Contractor · Phoenix, AZ

NPI 1124246004 · NPPES record last updated Jul 8, 2007

Key facts

NPI
1124246004
Entity type
Individual (NPI type 1)
Primary specialty
Contractor 171W00000X
License
3311 (AZ)
Practice address
455 N 3Rd St
Suite 200
Phoenix, AZ 85004-3924
Phone
(602) 528-3450
Fax
(602) 528-3439
NPI assigned
Apr 23, 2007
Sex
Female
Sole proprietor
Yes

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
No

State licenses

LicenseStateTypeSpecialty
3311AZMDContractor

Practice roles

OrganizationSpecialtyStatusNew patients
Essential Therapy Solutions, LLC Past Accepting new patients

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Contractor 171W00000X 3311 AZ Yes

Addresses

Primary practice location

455 N 3Rd St
Suite 200
Phoenix, AZ 85004-3924

Mailing address

12310 W Orange Dr
Litchfield Park, AZ 85340-4145
Phone (602) 403-9423

Other identifiers

IdentifierTypeStateIssuer
3311OtherAZOCCUPATIONAL THERAPIST

Other providers in Phoenix, AZ

All providers in Phoenix, AZ · Contractor in Arizona

Sources for this page

Verify at the official NPI Registry.