Developmental OT Services

Primary specialty

Pediatric Occupational TherapistTaxonomy code 225XP0200X

License

516 Issued in AZ

Legal business name

DEVELOPMENTAL OT SERVICES

Practice address

8521 W Cherry Hills Dr
Peoria, AZ 85345-8170

Phone

(623) 487-8616

NPI assigned

Nov 21, 2006

Organization subpart

No

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

Authorized official

Name

Mimi PruniskiNPI 1871668350

Title

Director

Phone

(623) 487-8616

Specialties & licenses 1

Addresses

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Mimi Pruniski, OTL

  • Pediatric Occupational Therapist
  • Peoria, AZ
  • NPI 1871668350

  Pediatrics

  NPD (past) Authorized official

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

{
    "created_epoch": "1164067200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1218412800000",
    "number": "1366517765",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8521 W CHERRY HILLS DR",
            "city": "PEORIA",
            "state": "AZ",
            "postal_code": "853458170",
            "telephone_number": "623-487-8616"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8521 W CHERRY HILLS DR",
            "city": "PEORIA",
            "state": "AZ",
            "postal_code": "853458170",
            "telephone_number": "623-487-8616"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DEVELOPMENTAL OT SERVICES",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-11-21",
        "last_updated": "2008-08-11",
        "status": "A",
        "authorized_official_last_name": "PRUNISKI",
        "authorized_official_first_name": "MIMI",
        "authorized_official_title_or_position": "DIRECTOR",
        "authorized_official_telephone_number": "623-487-8616"
    },
    "taxonomies": [
        {
            "code": "225XP0200X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Occupational Therapist, Pediatrics",
            "state": "AZ",
            "license": "516",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Pediatric Occupational Therapist in Peoria, AZ
• Providers in Peoria, AZ by specialty
• Pediatric Occupational Therapist in Arizona

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 11, 2008; 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.