Provider Demographics
NPI:1770815565
Name:LOPEZ, CHRISTY SCHEELER (OT)
Entity Type:Individual
Prefix:
First Name:CHRISTY
Middle Name:SCHEELER
Last Name:LOPEZ
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 1:35514 N 30TH DR
Mailing Address - Street 2:
Mailing Address - City:PHOENIX
Mailing Address - State:AZ
Mailing Address - Zip Code:85086-2116
Mailing Address - Country:US
Mailing Address - Phone:623-780-3435
Mailing Address - Fax:
Practice Address - Street 1:15508 W BELL RD
Practice Address - Street 2:STE 101-261
Practice Address - City:SURPRISE
Practice Address - State:AZ
Practice Address - Zip Code:85374-2432
Practice Address - Country:US
Practice Address - Phone:602-441-5975
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-02-04
Last Update Date:2010-02-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ2967225XP0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225XP0200XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistPediatrics