Provider Demographics
NPI:1083835235
Name:MCCLUER, AMY MARIE (COTA)
Entity Type:Individual
Prefix:MS
First Name:AMY
Middle Name:MARIE
Last Name:MCCLUER
Suffix:
Gender:F
Credentials:COTA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:P.O.BOX 5533
Mailing Address - Street 2:
Mailing Address - City:GLENDALE
Mailing Address - State:AZ
Mailing Address - Zip Code:85312-5533
Mailing Address - Country:US
Mailing Address - Phone:602-938-9012
Mailing Address - Fax:
Practice Address - Street 1:7071 W. HILLCREST BLVD.
Practice Address - Street 2:
Practice Address - City:GLENDALE
Practice Address - State:AZ
Practice Address - Zip Code:85310
Practice Address - Country:US
Practice Address - Phone:623-376-3975
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-05-02
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ1000224Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes224Z00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapy Assistant