Individual
MR. TREY NICHOLAS ANDERSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
COTA/L
Contact information
Practice address
5135 S QUANTUM WAY, MESA, AZ 85212-8148
(775) 385-0228
Mailing address
5135 S QUANTUM WAY, MESA, AZ 85212-8148
(775) 385-0228
Taxonomy
Speciality
Code
Description
License number
State
224Z00000X
Occupational Therapy Assistant
Primary
OTA-050180
AZ
Other
Enumeration date
08/12/2025
Last updated
08/12/2025
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