Provider Demographics
NPI:1780251892
Name:SALVATIERRA, CHELSEA R (OTR/L)
Entity type:Individual
Prefix:
First Name:CHELSEA
Middle Name:R
Last Name:SALVATIERRA
Suffix:
Gender:F
Credentials:OTR/L
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3660 W BETHANY HOME RD STE B
Mailing Address - Street 2:
Mailing Address - City:PHOENIX
Mailing Address - State:AZ
Mailing Address - Zip Code:85019-1953
Mailing Address - Country:US
Mailing Address - Phone:602-626-8851
Mailing Address - Fax:
Practice Address - Street 1:3660 W BETHANY HOME RD STE B
Practice Address - Street 2:
Practice Address - City:PHOENIX
Practice Address - State:AZ
Practice Address - Zip Code:85019-1953
Practice Address - Country:US
Practice Address - Phone:602-626-8851
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-06-08
Last Update Date:2021-06-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZOTH-007352225XP0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225XP0200XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistPediatrics