Basic Information
| Provider Information | |||||||||
| NPI: | 1528325719 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | MACLUER | ||||||||
| FirstName: | KATHLEEN | ||||||||
| MiddleName: | S | ||||||||
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| Credential: | PA, OT | ||||||||
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| Mailing Information | |||||||||
| Address1: | 1839 S ALMA SCHOOL RD STE 354 | ||||||||
| Address2: | |||||||||
| City: | MESA | ||||||||
| State: | AZ | ||||||||
| PostalCode: | 852103028 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 4807262287 | ||||||||
| FaxNumber: | |||||||||
| Practice Location | |||||||||
| Address1: | 2 N CENTRAL AVE STE 120 | ||||||||
| Address2: | |||||||||
| City: | PHOENIX | ||||||||
| State: | AZ | ||||||||
| PostalCode: | 850042972 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 6022964060 | ||||||||
| FaxNumber: | 6022964146 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 04/12/2012 | ||||||||
| LastUpdateDate: | 07/13/2020 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | Y | ||||||||
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| NPICertificationDate: | 07/13/2020 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 225X00000X | 6797 | AZ | N | Respiratory, Developmental, Rehabilitative and Restorative Service Providers | Occupational Therapist | 332B00000X | 7209350001 | AZ | N | Suppliers | Durable Medical Equipment & Medical Supplies | 332B00000X | 7057360001 | AZ | N | Suppliers | Durable Medical Equipment & Medical Supplies | 332B00000X | 7045160001 | AZ | N | Suppliers | Durable Medical Equipment & Medical Supplies | 332B00000X | 7046960001 | AZ | N | Suppliers | Durable Medical Equipment & Medical Supplies | 332B00000X | 7041750001 | AZ | N | Suppliers | Durable Medical Equipment & Medical Supplies | 332B00000X | 7629170001 | AZ | N | Suppliers | Durable Medical Equipment & Medical Supplies | 332B00000X | 7034950001 | AZ | N | Suppliers | Durable Medical Equipment & Medical Supplies | 363A00000X | 6727 | AZ | Y | Physician Assistants & Advanced Practice Nursing Providers | Physician Assistant |
No ID Information.