Provider Demographics
NPI:1720474810
Name:DELLACROCE, KRISTY (MS, OTR/L)
Entity type:Individual
Prefix:
First Name:KRISTY
Middle Name:
Last Name:DELLACROCE
Suffix:
Gender:F
Credentials:MS, OTR/L
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:16002 N 6TH PL
Mailing Address - Street 2:
Mailing Address - City:PHOENIX
Mailing Address - State:AZ
Mailing Address - Zip Code:85022-3063
Mailing Address - Country:US
Mailing Address - Phone:856-297-7437
Mailing Address - Fax:
Practice Address - Street 1:16002 N 6TH PL
Practice Address - Street 2:
Practice Address - City:PHOENIX
Practice Address - State:AZ
Practice Address - Zip Code:85022-3063
Practice Address - Country:US
Practice Address - Phone:856-297-7437
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2015-04-15
Last Update Date:2025-01-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZOTH-006161225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist