Provider Demographics
NPI:1982454690
Name:MURPHY, MIKAYLA (OT)
Entity Type:Individual
Prefix:
First Name:MIKAYLA
Middle Name:
Last Name:MURPHY
Suffix:
Gender:F
Credentials:OT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1860 N 95TH LN STE 105
Mailing Address - Street 2:
Mailing Address - City:PHOENIX
Mailing Address - State:AZ
Mailing Address - Zip Code:85037-4333
Mailing Address - Country:US
Mailing Address - Phone:623-907-0828
Mailing Address - Fax:623-907-3058
Practice Address - Street 1:1860 N 95TH LN STE 105
Practice Address - Street 2:
Practice Address - City:PHOENIX
Practice Address - State:AZ
Practice Address - Zip Code:85037-4333
Practice Address - Country:US
Practice Address - Phone:623-907-0828
Practice Address - Fax:623-907-3058
Is Sole Proprietor?:No
Enumeration Date:2024-03-25
Last Update Date:2024-03-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZOTH-009588225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist