Provider Demographics
NPI:1487847125
Name:PIFER, TARESA (OTR/L)
Entity type:Individual
Prefix:
First Name:TARESA
Middle Name:
Last Name:PIFER
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 1:301 N COTTONWOOD ST
Mailing Address - Street 2:
Mailing Address - City:CHANDLER
Mailing Address - State:AZ
Mailing Address - Zip Code:85225-4194
Mailing Address - Country:US
Mailing Address - Phone:480-273-4418
Mailing Address - Fax:
Practice Address - Street 1:844 N ELLSWORTH RD
Practice Address - Street 2:
Practice Address - City:MESA
Practice Address - State:AZ
Practice Address - Zip Code:85207-5114
Practice Address - Country:US
Practice Address - Phone:480-273-4418
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-08-27
Last Update Date:2010-05-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ3918225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist