Provider Demographics
NPI:1225341118
Name:COFFEY, ARIEL LEAH (OT)
Entity type:Individual
Prefix:
First Name:ARIEL
Middle Name:LEAH
Last Name:COFFEY
Suffix:
Gender:
Credentials:OT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:930 N SWITZER CANYON DR STE 102B
Mailing Address - Street 2:
Mailing Address - City:FLAGSTAFF
Mailing Address - State:AZ
Mailing Address - Zip Code:86001-4834
Mailing Address - Country:US
Mailing Address - Phone:928-600-4131
Mailing Address - Fax:480-393-5288
Practice Address - Street 1:525 N SWITZER CANYON DR
Practice Address - Street 2:
Practice Address - City:FLAGSTAFF
Practice Address - State:AZ
Practice Address - Zip Code:86001-4845
Practice Address - Country:US
Practice Address - Phone:928-773-2280
Practice Address - Fax:928-773-2281
Is Sole Proprietor?:No
Enumeration Date:2010-07-20
Last Update Date:2025-04-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ3244225XH1200X, 225XH1200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225XH1200XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistHand
Provider Identifiers
StateIdentifier IDID TypeIssuer
AZ3244OtherSTATE LICENSE
AZ538540Medicaid