Provider Demographics
NPI:1578056008
Name:KRANZ, JESSICA LEIGH CHARLOTTE (OTR/L)
Entity type:Individual
Prefix:
First Name:JESSICA
Middle Name:LEIGH CHARLOTTE
Last Name:KRANZ
Suffix:
Gender:F
Credentials:OTR/L
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5650 S KYRENE RD APT 1320
Mailing Address - Street 2:
Mailing Address - City:TEMPE
Mailing Address - State:AZ
Mailing Address - Zip Code:85283-1795
Mailing Address - Country:US
Mailing Address - Phone:757-879-5498
Mailing Address - Fax:
Practice Address - Street 1:3329 E BELL RD
Practice Address - Street 2:
Practice Address - City:PHOENIX
Practice Address - State:AZ
Practice Address - Zip Code:85032-2756
Practice Address - Country:US
Practice Address - Phone:602-258-4788
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-06-09
Last Update Date:2024-11-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZOTH-009846225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist