Provider Demographics
NPI:1235574351
Name:STEVENS, KALEIGH ADELE (MSOT/R)
Entity Type:Individual
Prefix:MRS
First Name:KALEIGH
Middle Name:ADELE
Last Name:STEVENS
Suffix:
Gender:F
Credentials:MSOT/R
Other - Prefix:MS
Other - First Name:KALEIGH
Other - Middle Name:ADELE
Other - Last Name:WARNER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MSOT/R
Mailing Address - Street 1:6520 W HAPPY VALLEY RD
Mailing Address - Street 2:SUITE B-109
Mailing Address - City:GLENDALE
Mailing Address - State:AZ
Mailing Address - Zip Code:85310-2615
Mailing Address - Country:US
Mailing Address - Phone:623-561-1300
Mailing Address - Fax:
Practice Address - Street 1:6520 W HAPPY VALLEY RD
Practice Address - Street 2:SUITE B-109
Practice Address - City:GLENDALE
Practice Address - State:AZ
Practice Address - Zip Code:85310-2615
Practice Address - Country:US
Practice Address - Phone:623-561-1300
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2013-05-02
Last Update Date:2013-05-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ5467225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist