Shirley A. Auchincloss, OTR OTRL

Individual provider Active NPI Occupational Therapist · Sierra Vista, AZ

NPI 1154401917 · NPPES record last updated Feb 5, 2008

Key facts

NPI
1154401917
Entity type
Individual (NPI type 1)
Primary specialty
Occupational Therapist 225X00000X
License
0022 (AZ)
Practice address
5528 S Laguna Ave
Sierra Vista, AZ 85650-9770
Phone
(520) 803-9733
Fax
(520) 803-9420
NPI assigned
Oct 16, 2006
Sex
Female
Sole proprietor
No

Medicare participation

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

National Provider Directory

Medicare enrollment (NPD)
Yes

State licenses

LicenseStateTypeSpecialty
0022AZMDOccupational Therapist

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Occupational Therapist 225X00000X 0022 AZ Yes

Addresses

Primary practice location

5528 S Laguna Ave
Sierra Vista, AZ 85650-9770

Mailing address

5528 S Laguna Ave
Sierra Vista, AZ 85650-9770
Phone (520) 803-9733

Other identifiers

IdentifierTypeStateIssuer
771049MedicaidAZ

Other providers in Sierra Vista, AZ

All providers in Sierra Vista, AZ · Occupational Therapist in Arizona

Sources for this page

Verify at the official NPI Registry.