Provider Demographics
NPI:1396019162
Name:NOTHNAGEL, MARGERY (COTA/L)
Entity Type:Individual
Prefix:
First Name:MARGERY
Middle Name:
Last Name:NOTHNAGEL
Suffix:
Gender:F
Credentials:COTA/L
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:16617 N WEST POINT PKWY
Mailing Address - Street 2:APT.#109
Mailing Address - City:SURPRISE
Mailing Address - State:AZ
Mailing Address - Zip Code:85374-4016
Mailing Address - Country:US
Mailing Address - Phone:480-220-8848
Mailing Address - Fax:
Practice Address - Street 1:14154 S DENNY BLVD
Practice Address - Street 2:
Practice Address - City:LITCHFIELD PARK
Practice Address - State:AZ
Practice Address - Zip Code:85340-9431
Practice Address - Country:US
Practice Address - Phone:623-537-7500
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2012-02-26
Last Update Date:2012-02-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ1841224Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes224Z00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapy Assistant