Provider Demographics
NPI:1922814383
Name:ALC THERAPY SERVICES
Entity type:Organization
Organization Name:ALC THERAPY SERVICES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OCCUPATION THERAPIST
Authorized Official - Prefix:
Authorized Official - First Name:ARIEL
Authorized Official - Middle Name:LEAH
Authorized Official - Last Name:COFFEY
Authorized Official - Suffix:
Authorized Official - Credentials:OTR/L, CHT
Authorized Official - Phone:928-600-4131
Mailing Address - Street 1:930 N SWITZER CANYON DR STE 102B
Mailing Address - Street 2:
Mailing Address - City:FLAGSTAFF
Mailing Address - State:AZ
Mailing Address - Zip Code:86001-4834
Mailing Address - Country:US
Mailing Address - Phone:928-600-4131
Mailing Address - Fax:
Practice Address - Street 1:930 N SWITZER CANYON DR STE 102B
Practice Address - Street 2:
Practice Address - City:FLAGSTAFF
Practice Address - State:AZ
Practice Address - Zip Code:86001-4834
Practice Address - Country:US
Practice Address - Phone:928-600-4131
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-12-09
Last Update Date:2024-12-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistGroup - Single Specialty