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Search › Arizona › Occupational Therapy Assistant

Edward Russell, COTAL

NPI 1730599226 · on the registry since 2014 · sole proprietor

Practice

Address
5358 E Baseline Rd
Mesa, AZ 85206
Phone
(480) 630-3005
Organisation at this address
Se Mesa Opco, Llc
Asante Of Mesa, Llc
Inferred from a shared address, not stated in the registry.
Clinicians at this address
13

Registry record

Primary taxonomy
Occupational Therapy Assistant
224Z00000X
Licence states on file
AZ
From the registry's licence fields, which are often incomplete.
Sex
Male
Record last updated
2014-05-06

Source: CMS National Plan and Provider Enumeration System. Registration is not the same as practising, and the registry records no retirement — some people listed here no longer practise. More in Arizona