Provider Demographics
NPI:1730955139
Name:MCLAUGHLIN, MERCADIE (COTA/L)
Entity type:Individual
Prefix:
First Name:MERCADIE
Middle Name:
Last Name:MCLAUGHLIN
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 1:34472 S SPIRIT LN
Mailing Address - Street 2:
Mailing Address - City:RED ROCK
Mailing Address - State:AZ
Mailing Address - Zip Code:85145-6027
Mailing Address - Country:US
Mailing Address - Phone:520-240-8490
Mailing Address - Fax:
Practice Address - Street 1:43507 N IRONWOOD DR
Practice Address - Street 2:
Practice Address - City:QUEEN CREEK
Practice Address - State:AZ
Practice Address - Zip Code:85140-9312
Practice Address - Country:US
Practice Address - Phone:480-757-2253
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-11-28
Last Update Date:2023-11-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZOTA-047306224Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes224Z00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapy Assistant