Provider Demographics
NPI:1598249807
Name:ARQUERO, CAMILLE (AAS, COTA/L)
Entity Type:Individual
Prefix:
First Name:CAMILLE
Middle Name:
Last Name:ARQUERO
Suffix:
Gender:F
Credentials:AAS, COTA/L
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5102 E PIEDMONT RD APT 2248
Mailing Address - Street 2:
Mailing Address - City:PHOENIX
Mailing Address - State:AZ
Mailing Address - Zip Code:85044-8620
Mailing Address - Country:US
Mailing Address - Phone:602-575-5460
Mailing Address - Fax:
Practice Address - Street 1:4309 E FLORIAN AVE
Practice Address - Street 2:
Practice Address - City:MESA
Practice Address - State:AZ
Practice Address - Zip Code:85206-2798
Practice Address - Country:US
Practice Address - Phone:480-757-2253
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-09-21
Last Update Date:2018-09-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ6352224Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes224Z00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapy Assistant