Provider Demographics
NPI:1295510022
Name:LESPERANCE, RAYAH NORA (COTA/L)
Entity type:Individual
Prefix:
First Name:RAYAH
Middle Name:NORA
Last Name:LESPERANCE
Suffix:
Gender:F
Credentials:COTA/L
Other - Prefix:
Other - First Name:RAYAH
Other - Middle Name:NORA
Other - Last Name:LESPERANCE
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:COTA/L
Mailing Address - Street 1:10416 E JAN AVE
Mailing Address - Street 2:
Mailing Address - City:MESA
Mailing Address - State:AZ
Mailing Address - Zip Code:85209-7729
Mailing Address - Country:US
Mailing Address - Phone:480-529-7186
Mailing Address - Fax:
Practice Address - Street 1:43507 N IRONWOOD DR
Practice Address - Street 2:
Practice Address - City:QUEEN CREEK
Practice Address - State:AZ
Practice Address - Zip Code:85140-9312
Practice Address - Country:US
Practice Address - Phone:480-757-2253
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-08-29
Last Update Date:2023-08-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ047273224Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes224Z00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapy Assistant