Provider Demographics
NPI:1578831988
Name:E-MOTION THERAPY SERVICES
Entity type:Organization
Organization Name:E-MOTION THERAPY SERVICES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/OCCUPATIONAL THERAPIST
Authorized Official - Prefix:MS
Authorized Official - First Name:PHAEDRA
Authorized Official - Middle Name:
Authorized Official - Last Name:ANTIOCO
Authorized Official - Suffix:
Authorized Official - Credentials:OTR/L
Authorized Official - Phone:480-442-8060
Mailing Address - Street 1:3801 E PARK AVE
Mailing Address - Street 2:
Mailing Address - City:PHOENIX
Mailing Address - State:AZ
Mailing Address - Zip Code:85044-8255
Mailing Address - Country:US
Mailing Address - Phone:520-401-1081
Mailing Address - Fax:480-306-7780
Practice Address - Street 1:7331 E OSBORN DR
Practice Address - Street 2:SUITE 330
Practice Address - City:SCOTTSDALE
Practice Address - State:AZ
Practice Address - Zip Code:85251-6435
Practice Address - Country:US
Practice Address - Phone:480-442-8060
Practice Address - Fax:480-306-7780
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-12-13
Last Update Date:2011-12-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ2668261QR0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QR0400XAmbulatory Health Care FacilitiesClinic/CenterRehabilitation