Provider Demographics
NPI:1861658361
Name:GESS, JANNA RENEE (COTA/L)
Entity Type:Individual
Prefix:MRS
First Name:JANNA
Middle Name:RENEE
Last Name:GESS
Suffix:
Gender:F
Credentials:COTA/L
Other - Prefix:MS
Other - First Name:JANNA
Other - Middle Name:R
Other - Last Name:LAMLE
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:COTA/L
Mailing Address - Street 1:4053 W VILLA RITA DR
Mailing Address - Street 2:
Mailing Address - City:GLENDALE
Mailing Address - State:AZ
Mailing Address - Zip Code:85308-2605
Mailing Address - Country:US
Mailing Address - Phone:602-942-3399
Mailing Address - Fax:
Practice Address - Street 1:12409 W INDIAN SCHOOL RD
Practice Address - Street 2:
Practice Address - City:AVONDALE
Practice Address - State:AZ
Practice Address - Zip Code:85392-9502
Practice Address - Country:US
Practice Address - Phone:623-935-6040
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2008-08-04
Last Update Date:2008-08-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ2137224Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes224Z00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapy Assistant