Provider Demographics
NPI:1467191288
Name:ALLEN, ALLISON (COTA/L)
Entity Type:Individual
Prefix:MRS
First Name:ALLISON
Middle Name:
Last Name:ALLEN
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 1:1878 E MAGDALENA DR
Mailing Address - Street 2:
Mailing Address - City:TEMPE
Mailing Address - State:AZ
Mailing Address - Zip Code:85283-2261
Mailing Address - Country:US
Mailing Address - Phone:623-824-8825
Mailing Address - Fax:
Practice Address - Street 1:10631 S 51ST ST STE 1
Practice Address - Street 2:
Practice Address - City:PHOENIX
Practice Address - State:AZ
Practice Address - Zip Code:85044-5225
Practice Address - Country:US
Practice Address - Phone:480-398-4280
Practice Address - Fax:480-398-4281
Is Sole Proprietor?:Yes
Enumeration Date:2022-05-31
Last Update Date:2022-05-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes224Z00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapy AssistantGroup - Multi-Specialty