Provider Demographics
NPI:1346846235
Name:TERAN ALVARADO, KORINNA CHEYENNE (OTD, OTR/L)
Entity Type:Individual
Prefix:DR
First Name:KORINNA
Middle Name:CHEYENNE
Last Name:TERAN ALVARADO
Suffix:
Gender:F
Credentials:OTD, OTR/L
Other - Prefix:DR
Other - First Name:KORINNA
Other - Middle Name:CHEYENNE
Other - Last Name:ALVARADO
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:OTD, OTR/L
Mailing Address - Street 1:2260 N ROSEMONT BLVD STE 100
Mailing Address - Street 2:
Mailing Address - City:TUCSON
Mailing Address - State:AZ
Mailing Address - Zip Code:85712-2137
Mailing Address - Country:US
Mailing Address - Phone:520-232-2021
Mailing Address - Fax:520-232-2553
Practice Address - Street 1:2260 N ROSEMONT BLVD STE 100
Practice Address - Street 2:
Practice Address - City:TUCSON
Practice Address - State:AZ
Practice Address - Zip Code:85712-2137
Practice Address - Country:US
Practice Address - Phone:520-232-2021
Practice Address - Fax:520-232-2553
Is Sole Proprietor?:No
Enumeration Date:2020-12-07
Last Update Date:2020-12-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZOTH008150225XP0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225XP0200XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistPediatrics