Individual provider · Type 1 NPI

Edward John Russell Iii, COTAL

Occupational Therapy Assistant · Mesa, AZ

NPI number 1730599226 Active

Practice location

5358 E Baseline Rd
Mesa, AZ 85206-4716

Call (480) 630-3005 Map

Mailing address

25117 SW Parkway Ave Ste D
Wilsonville, OR 97070-9697

Specialties and licenses

TaxonomyCodeLicense
Occupational Therapy Assistant Primary 224Z00000X5776 (AZ)

Occupational Therapy Assistant: An occupational therapy assistant is a person who has graduated from an occupational therapy assistant program accredited by the Accreditation Council for Occupational Therapy Education (ACOTE) or predecessor organizations, has successfully completed a period of supervised fieldwork experience required by the accredited occupational therapy assistant program, has passed a nationally recognized entry-level examinatio…

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About NPI 1730599226

Edward John Russell Iii, COTAL's National Provider Identifier is 1730599226, issued on May 6, 2014. The primary taxonomy on file is Occupational Therapy Assistant (224Z00000X), and the practice location is in Mesa, AZ. The record was last updated on May 6, 2014.