Provider Demographics
NPI:1306453667
Name:MCCUTCHEON, KASEY (OTR)
Entity type:Individual
Prefix:
First Name:KASEY
Middle Name:
Last Name:MCCUTCHEON
Suffix:
Gender:F
Credentials:OTR
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2911 E MUIRWOOD DR
Mailing Address - Street 2:
Mailing Address - City:PHOENIX
Mailing Address - State:AZ
Mailing Address - Zip Code:85048-7752
Mailing Address - Country:US
Mailing Address - Phone:412-779-8426
Mailing Address - Fax:
Practice Address - Street 1:4645 E CHANDLER BLVD STE 100
Practice Address - Street 2:
Practice Address - City:PHOENIX
Practice Address - State:AZ
Practice Address - Zip Code:85048-0432
Practice Address - Country:US
Practice Address - Phone:412-779-8426
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-09-29
Last Update Date:2023-01-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225XP0200XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistPediatrics