Provider Demographics
NPI:1942373899
Name:GARZA, JENNIFER CLAIRE (OTR/L, CHT)
Entity Type:Individual
Prefix:MRS
First Name:JENNIFER
Middle Name:CLAIRE
Last Name:GARZA
Suffix:
Gender:F
Credentials:OTR/L, CHT
Other - Prefix:MS
Other - First Name:JENNIFER
Other - Middle Name:CLAIRE
Other - Last Name:COSTA
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:OTR/L, CHT
Mailing Address - Street 1:1941 W GUADALUPE RD
Mailing Address - Street 2:SUITE 108
Mailing Address - City:MESA
Mailing Address - State:AZ
Mailing Address - Zip Code:85202-7482
Mailing Address - Country:US
Mailing Address - Phone:480-491-3563
Mailing Address - Fax:480-491-3572
Practice Address - Street 1:1941 W GUADALUPE RD
Practice Address - Street 2:SUITE 108
Practice Address - City:MESA
Practice Address - State:AZ
Practice Address - Zip Code:85202-7482
Practice Address - Country:US
Practice Address - Phone:480-491-3563
Practice Address - Fax:480-491-3572
Is Sole Proprietor?:Yes
Enumeration Date:2006-11-16
Last Update Date:2008-01-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ2835225XH1200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225XH1200XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistHand
Provider Identifiers
StateIdentifier IDID TypeIssuer
AZ036551Medicare ID - Type Unspecified