Ashley Dietz, COTA/L

Individual provider Active NPI Occupational Therapy Assistant · Grand Island, NY

NPI 1164070025 · NPPES record last updated Sep 3, 2019

Key facts

NPI
1164070025
Entity type
Individual (NPI type 1)
Primary specialty
Occupational Therapy Assistant 224Z00000X
License
010203-01 (NY)
Practice address
2451 Baseline Rd
Grand Island, NY 14072-1657
Phone
(716) 773-8870
NPI assigned
Sep 3, 2019
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
010203-01NYMDOccupational Therapy Assistant

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Occupational Therapy Assistant 224Z00000X 010203-01 NY Yes

Addresses

Primary practice location

2451 Baseline Rd
Grand Island, NY 14072-1657

Mailing address

112 Weyand Ave
Buffalo, NY 14210-2371
Phone (716) 308-2205

Other providers in Grand Island, NY

All providers in Grand Island, NY · Occupational Therapy Assistant in New York

Sources for this page

Verify at the official NPI Registry.