Elizabeth M Wade, COTA

Individual provider Active NPI Occupational Therapy Assistant · Wakarusa, IN

NPI 1093422008 · NPPES record last updated Oct 31, 2022

Key facts

NPI
1093422008
Entity type
Individual (NPI type 1)
Primary specialty
Occupational Therapy Assistant 224Z00000X
License
32002000A (IN)
Practice address
303 N Washington St
Wakarusa, IN 46573-9590
Phone
(574) 862-4511
NPI assigned
Oct 31, 2022
Sex
Female
Sole proprietor
No

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
No

State licenses

LicenseStateTypeSpecialty
32002000AINMDOccupational Therapy Assistant

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Occupational Therapy Assistant 224Z00000X 32002000A IN Yes

Addresses

Primary practice location

303 N Washington St
Wakarusa, IN 46573-9590

Mailing address

22327 Sommerset Place Blvd
Goshen, IN 46528-8317
Phone (574) 215-2035

Other providers in Wakarusa, IN

All providers in Wakarusa, IN · Occupational Therapy Assistant in Indiana

Sources for this page

Verify at the official NPI Registry.