Provider Demographics
NPI:1962708099
Name:CANELLA, ANNETTE M (OTR/L)
Entity type:Individual
Prefix:
First Name:ANNETTE
Middle Name:M
Last Name:CANELLA
Suffix:
Gender:F
Credentials:OTR/L
Other - Prefix:
Other - First Name:ANNETTE
Other - Middle Name:M
Other - Last Name:SCURTI
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:8115 E INDIAN BEND RD
Mailing Address - Street 2:STE 123
Mailing Address - City:SCOTTSDALE
Mailing Address - State:AZ
Mailing Address - Zip Code:85250-4819
Mailing Address - Country:US
Mailing Address - Phone:480-951-6451
Mailing Address - Fax:
Practice Address - Street 1:21630 N 19TH AVE STE B3
Practice Address - Street 2:
Practice Address - City:PHOENIX
Practice Address - State:AZ
Practice Address - Zip Code:85027-2717
Practice Address - Country:US
Practice Address - Phone:602-726-2300
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2011-02-08
Last Update Date:2020-04-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ4737225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist