Chelsea Rae Tedford, COTA

Individual provider Active NPI Occupational Therapy Assistant · Willcox, AZ

NPI 1790404663 · NPPES record last updated Aug 24, 2022

Key facts

NPI
1790404663
Entity type
Individual (NPI type 1)
Primary specialty
Occupational Therapy Assistant 224Z00000X
License
OTA-006897 (AZ)
Practice address
1625 N Circle Rd
Willcox, AZ 85602
Phone
(520) 507-1627
NPI assigned
Aug 24, 2022
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)
No

State licenses

LicenseStateTypeSpecialty
OTA-006897AZMDOccupational Therapy Assistant

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Occupational Therapy Assistant 224Z00000X OTA-006897 AZ Yes

Addresses

Primary practice location

1625 N Circle Rd
Willcox, AZ 85602

Mailing address

1990 N Ocotillo Rd
Benson, AZ 85602-8018
Phone (520) 216-8123

Other providers in Willcox, AZ

All providers in Willcox, AZ · Occupational Therapy Assistant in Arizona

Sources for this page

Verify at the official NPI Registry.