Provider Demographics
NPI:1073070348
Name:ANDRUS, ANNA JEANETTE (MS, OT R/L)
Entity Type:Individual
Prefix:MRS
First Name:ANNA
Middle Name:JEANETTE
Last Name:ANDRUS
Suffix:
Gender:F
Credentials:MS, OT R/L
Other - Prefix:MS
Other - First Name:ANNA
Other - Middle Name:
Other - Last Name:LANDRY
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:7349 N VIA PASEO DEL SUR # 442
Mailing Address - Street 2:
Mailing Address - City:SCOTTSDALE
Mailing Address - State:AZ
Mailing Address - Zip Code:85258-3765
Mailing Address - Country:US
Mailing Address - Phone:480-447-3262
Mailing Address - Fax:480-630-2066
Practice Address - Street 1:16413 N 91ST ST STE 145
Practice Address - Street 2:
Practice Address - City:SCOTTSDALE
Practice Address - State:AZ
Practice Address - Zip Code:85260-3056
Practice Address - Country:US
Practice Address - Phone:480-447-3262
Practice Address - Fax:480-630-2066
Is Sole Proprietor?:Yes
Enumeration Date:2019-02-22
Last Update Date:2019-02-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZOTH-006295225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist