Provider Demographics
NPI:1043689052
Name:REID, GRACE ELIZABETH (MOT, OTR/L)
Entity type:Individual
Prefix:MS
First Name:GRACE
Middle Name:ELIZABETH
Last Name:REID
Suffix:
Gender:F
Credentials:MOT, OTR/L
Other - Prefix:MS
Other - First Name:GRACE
Other - Middle Name:ELIZABETH
Other - Last Name:PELZEL
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:COTA/L
Mailing Address - Street 1:7744 W RUNNING BEAR DR
Mailing Address - Street 2:
Mailing Address - City:TUCSON
Mailing Address - State:AZ
Mailing Address - Zip Code:85743-1106
Mailing Address - Country:US
Mailing Address - Phone:520-989-1187
Mailing Address - Fax:
Practice Address - Street 1:167 N MAIN ST
Practice Address - Street 2:
Practice Address - City:TUBA CITY
Practice Address - State:AZ
Practice Address - Zip Code:86045-0600
Practice Address - Country:US
Practice Address - Phone:928-283-2873
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2015-09-20
Last Update Date:2024-05-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZOTH-009114225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist