Provider Demographics
NPI:1134551567
Name:SANCHEZ, KAYLA BERNICE (COTA/L)
Entity type:Individual
Prefix:
First Name:KAYLA
Middle Name:BERNICE
Last Name:SANCHEZ
Suffix:
Gender:F
Credentials:COTA/L
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10240 E ASTER LN
Mailing Address - Street 2:
Mailing Address - City:FLORENCE
Mailing Address - State:AZ
Mailing Address - Zip Code:85132-7183
Mailing Address - Country:US
Mailing Address - Phone:480-238-4111
Mailing Address - Fax:
Practice Address - Street 1:10240 E ASTER LN
Practice Address - Street 2:
Practice Address - City:FLORENCE
Practice Address - State:AZ
Practice Address - Zip Code:85132-7183
Practice Address - Country:US
Practice Address - Phone:480-238-4111
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2013-08-08
Last Update Date:2013-08-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ5426224Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes224Z00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapy Assistant