Provider Demographics
NPI:1306678669
Name:ESQUIVEL, YOLANDA (OTR)
Entity type:Individual
Prefix:
First Name:YOLANDA
Middle Name:
Last Name:ESQUIVEL
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 1:3111 CLEARWATER DR STE C3111
Mailing Address - Street 2:
Mailing Address - City:PRESCOTT
Mailing Address - State:AZ
Mailing Address - Zip Code:86305-7186
Mailing Address - Country:US
Mailing Address - Phone:928-777-9890
Mailing Address - Fax:
Practice Address - Street 1:3111 CLEARWATER DR STE C3111
Practice Address - Street 2:
Practice Address - City:PRESCOTT
Practice Address - State:AZ
Practice Address - Zip Code:86305-7186
Practice Address - Country:US
Practice Address - Phone:928-777-9890
Practice Address - Fax:928-777-9891
Is Sole Proprietor?:Yes
Enumeration Date:2024-08-15
Last Update Date:2024-08-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZAA395145225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistGroup - Single Specialty