Provider Demographics
NPI:1679880330
Name:MCCARTHY, VANESSA MARIE (MS, OTR/L)
Entity Type:Individual
Prefix:
First Name:VANESSA
Middle Name:MARIE
Last Name:MCCARTHY
Suffix:
Gender:F
Credentials:MS, OTR/L
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3031 W COTTONWOOD LN
Mailing Address - Street 2:
Mailing Address - City:PHOENIX
Mailing Address - State:AZ
Mailing Address - Zip Code:85045-2232
Mailing Address - Country:US
Mailing Address - Phone:480-662-5391
Mailing Address - Fax:480-757-7019
Practice Address - Street 1:3031 W COTTONWOOD LN
Practice Address - Street 2:
Practice Address - City:PHOENIX
Practice Address - State:AZ
Practice Address - Zip Code:85045-2232
Practice Address - Country:US
Practice Address - Phone:480-662-5391
Practice Address - Fax:480-757-7019
Is Sole Proprietor?:No
Enumeration Date:2010-09-01
Last Update Date:2018-09-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ4548225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist