Provider Demographics
NPI:1689677627
Name:WARD, CARRIE A (OT)
Entity Type:Individual
Prefix:MS
First Name:CARRIE
Middle Name:A
Last Name:WARD
Suffix:
Gender:F
Credentials:OT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 32490
Mailing Address - Street 2:
Mailing Address - City:PHOENIX
Mailing Address - State:AZ
Mailing Address - Zip Code:85064-2490
Mailing Address - Country:US
Mailing Address - Phone:602-230-4478
Mailing Address - Fax:602-230-9962
Practice Address - Street 1:3050 N LITCHFIELD RD
Practice Address - Street 2:STE 100
Practice Address - City:GOODYEAR
Practice Address - State:AZ
Practice Address - Zip Code:85395-7804
Practice Address - Country:US
Practice Address - Phone:623-935-5505
Practice Address - Fax:623-935-5551
Is Sole Proprietor?:No
Enumeration Date:2005-05-23
Last Update Date:2007-10-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ2430225XH1200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225XH1200XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistHand
Provider Identifiers
StateIdentifier IDID TypeIssuer
AZ854689Medicaid
AZZ80574Medicare PIN