Individual
SHAENA LUTZ
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
COTA/L
Contact information
Practice address
1889 W QUEEN CREEK RD, #2062, CHANDLER, AZ 85248-3079
(602) 410-3062
Mailing address
1889 WEST QUEEN CREEK ROAD, #2062, CHANDLER, AZ 85248
(602) 410-3062
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
6216
AZ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
6216
OCCUPATIONAL THERAPY ASSISTANT
AZ
Enumeration date
07/23/2015
Last updated
07/23/2015
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