Provider Demographics
NPI:1477025229
Name:TARDONE, ERICA (MOT, OTR/L)
Entity Type:Individual
Prefix:
First Name:ERICA
Middle Name:
Last Name:TARDONE
Suffix:
Gender:F
Credentials:MOT, OTR/L
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8550 E MCDOWELL RD APT 144
Mailing Address - Street 2:
Mailing Address - City:SCOTTSDALE
Mailing Address - State:AZ
Mailing Address - Zip Code:85257-3949
Mailing Address - Country:US
Mailing Address - Phone:315-391-8817
Mailing Address - Fax:
Practice Address - Street 1:690 E WARNER RD STE 105
Practice Address - Street 2:
Practice Address - City:GILBERT
Practice Address - State:AZ
Practice Address - Zip Code:85296-3055
Practice Address - Country:US
Practice Address - Phone:480-820-6366
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-12-18
Last Update Date:2023-03-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZOTH-007707225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist