Provider Demographics
NPI:1376116616
Name:O'CONNOR, CLAIRE A (OT)
Entity Type:Individual
Prefix:
First Name:CLAIRE
Middle Name:A
Last Name:O'CONNOR
Suffix:
Gender:F
Credentials:OT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1652 E CRESCENT WAY
Mailing Address - Street 2:
Mailing Address - City:CHANDLER
Mailing Address - State:AZ
Mailing Address - Zip Code:85249-4756
Mailing Address - Country:US
Mailing Address - Phone:650-302-0906
Mailing Address - Fax:
Practice Address - Street 1:500 S ARROWHEAD DR
Practice Address - Street 2:
Practice Address - City:CHANDLER
Practice Address - State:AZ
Practice Address - Zip Code:85224-7500
Practice Address - Country:US
Practice Address - Phone:480-812-6267
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-07-23
Last Update Date:2021-07-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
AZ86-6000515Medicaid