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CALLIE DEVRIES COTA
>> Occupational Therapy Assistant >> Respiratory, Developmental, Rehabilitative and Restorative Service ProvidersRegistrant NPI Number: 1962094797
Individual Registrant: CALLIE DEVRIES COTA
Gender: F
Not Sole Proprietor
Gender: F
Not Sole Proprietor
Location and contact information for practice:
N7831 LOUISE LN RANDOLPH, WI 53956-9758 US
Tel: 920-296-1713 Fax: --
Tel: 920-296-1713 Fax: --
Contact information for business:
N7831 LOUISE LN RANDOLPH, WI 53956-9758 US
Tel: 920-296-1713 Fax: --
Tel: 920-296-1713 Fax: --
Registration Information:
NPI: 1962094797
Entity Type: Individual
Entity Type: Individual
Specialty information:
| Primary | Code | Category/Description | State | License Number |
|---|---|---|---|---|
| Y | 224Z00000X | Respiratory, Developmental, Rehabilitative and Restorative Service Providers Occupational Therapy Assistant | WI | 5746-27 |
Legacy codes, insurance codes and state license numbers:
| Issuer | Number | State | Type |
|---|---|---|---|
