Michele Lee Moreno

Individual provider Active NPI Occupational Therapist · Phoenix, AZ

NPI 1285840231 · NPPES record last updated Jul 8, 2007

Key facts

NPI
1285840231
Entity type
Individual (NPI type 1)
Primary specialty
Occupational Therapist 225X00000X
License
3327 (AZ)
Practice address
455 N 3Rd St Ste 200
Phoenix, AZ 85004-3932
Phone
(602) 528-3450
NPI assigned
May 15, 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
3327AZMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Essential Therapy Solutions, LLC Past Accepting new patients

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Occupational Therapist 225X00000X 3327 AZ Yes

Addresses

Primary practice location

455 N 3Rd St Ste 200
Phoenix, AZ 85004-3932

Mailing address

1990 McCulloch Blvd N # D-104
Lake Havasu City, AZ 86403-5749
Phone (928) 566-9933

Other providers in Phoenix, AZ

All providers in Phoenix, AZ · Occupational Therapist in Arizona

Sources for this page

Verify at the official NPI Registry.