Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 225X00000X | Occupational Therapist | OTH-002760 | AZ |
N | 225XE0001X | Environmental Modification | OTH-002760 | AZ |
N | 2251E1200X | Ergonomics | OTH-002760 | AZ |
N | 225XE1200X | Ergonomics | OTH-002760 | AZ |
N | 225XF0002X | Feeding, Eating & Swallowing | OTH-002760 | AZ |
N | 225XG0600X | Occupational Therapist - Gerontology | OTH-002760 | AZ |
N | 225XH1200X | Occupational Therapist - Hand | OTH-002760 | AZ |
N | 2251H1300X | Human Factors | OTH-002760 | AZ |
N | 225XH1300X | Human Factors | OTH-002760 | AZ |
N | 225XL0004X | Low Vision | OTH-002760 | AZ |
N | 225XM0800X | Mental Health | OTH-002760 | AZ |
N | 225XN1300X | Occupational Therapist - Neurorehabilitation | OTH-002760 | AZ |
N | 225XP0019X | Occupational Therapist - Physical Rehabilitation | OTH-002760 | AZ |
N | 225XP0200X | Occupational Therapist - Pediatrics | OTH-002760 | AZ |
N | 225XR0403X | Driving and Community Mobility | OTH-002760 | AZ |
NPI | 1093339731 |
---|---|
Provider Name | Michael Lewis Simmons |
First Address | Chandler, AZ 85249-4624 |
Second Address | Gilbert, AZ 85234-2471 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 28/05/2020 |
Last Update Date | 28/05/2020 |