Provider Demographics
NPI:1811385651
Name:AURANDT, CARLA JOAN (COTA/L)
Entity Type:Individual
Prefix:
First Name:CARLA
Middle Name:JOAN
Last Name:AURANDT
Suffix:
Gender:F
Credentials:COTA/L
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2413 E MEADOW LARK WAY
Mailing Address - Street 2:
Mailing Address - City:SAN TAN VALLEY
Mailing Address - State:AZ
Mailing Address - Zip Code:85140-5621
Mailing Address - Country:US
Mailing Address - Phone:520-271-6164
Mailing Address - Fax:
Practice Address - Street 1:43491 N COYOTE RD
Practice Address - Street 2:
Practice Address - City:SAN TAN VALLEY
Practice Address - State:AZ
Practice Address - Zip Code:85140-8924
Practice Address - Country:US
Practice Address - Phone:602-421-7718
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2015-01-01
Last Update Date:2015-01-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ5946224Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes224Z00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapy Assistant