Provider Demographics
NPI:1558917427
Name:VELEZ, TARA (DPT)
Entity Type:Individual
Prefix:
First Name:TARA
Middle Name:
Last Name:VELEZ
Suffix:
Gender:F
Credentials:DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:16700 N THOMPSON PEAK PKWY STE 220
Mailing Address - Street 2:
Mailing Address - City:SCOTTSDALE
Mailing Address - State:AZ
Mailing Address - Zip Code:85260-2387
Mailing Address - Country:US
Mailing Address - Phone:480-629-4606
Mailing Address - Fax:480-629-8511
Practice Address - Street 1:14202 N SCOTTSDALE RD STE 169
Practice Address - Street 2:
Practice Address - City:SCOTTSDALE
Practice Address - State:AZ
Practice Address - Zip Code:85254-4081
Practice Address - Country:US
Practice Address - Phone:480-821-1997
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-08-15
Last Update Date:2021-04-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZLPT-30837225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist