Provider Demographics
NPI:1528104320
Name:CUTTLER, CARLINA (OTR)
Entity type:Individual
Prefix:
First Name:CARLINA
Middle Name:
Last Name:CUTTLER
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 1:20815 N 25TH PL
Mailing Address - Street 2:SUITE 105
Mailing Address - City:PHOENIX
Mailing Address - State:AZ
Mailing Address - Zip Code:85050-4608
Mailing Address - Country:US
Mailing Address - Phone:602-404-8102
Mailing Address - Fax:602-466-2834
Practice Address - Street 1:20815 N 25TH PL
Practice Address - Street 2:SUITE 105
Practice Address - City:PHOENIX
Practice Address - State:AZ
Practice Address - Zip Code:85050-4608
Practice Address - Country:US
Practice Address - Phone:602-404-8102
Practice Address - Fax:602-466-2834
Is Sole Proprietor?:No
Enumeration Date:2007-01-29
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ0097225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
AZ771065OtherAHCCCS
AZAZ0461360OtherBLUE CROSS BLUE SHIELD