Provider Demographics
NPI:1447310941
Name:ARENZ, VICKI LYNN (OTR L)
Entity type:Individual
Prefix:MRS
First Name:VICKI
Middle Name:LYNN
Last Name:ARENZ
Suffix:
Gender:F
Credentials:OTR L
Other - Prefix:MISS
Other - First Name:VICKI
Other - Middle Name:LYNN
Other - Last Name:ARENZ
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:OTR L
Mailing Address - Street 1:519 E CANTEBRIA DR
Mailing Address - Street 2:
Mailing Address - City:GILBERT
Mailing Address - State:AZ
Mailing Address - Zip Code:85296-3515
Mailing Address - Country:US
Mailing Address - Phone:480-892-9781
Mailing Address - Fax:
Practice Address - Street 1:3205 S RURAL RD
Practice Address - Street 2:
Practice Address - City:TEMPE
Practice Address - State:AZ
Practice Address - Zip Code:85282-3853
Practice Address - Country:US
Practice Address - Phone:480-730-7100
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-12-12
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ1035225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist