Rashanda Gay, COTA-L

Individual provider Active NPI Occupational Therapy Assistant · Aledo, IL

NPI 1164096202 · NPPES record last updated Oct 28, 2022

Key facts

NPI
1164096202
Entity type
Individual (NPI type 1)
Primary specialty
Occupational Therapy Assistant 224Z00000X
License
057005465 (IL)
Practice address
304 SW 12TH St
Aledo, IL 61231-2707
Phone
(309) 582-5376
NPI assigned
May 13, 2021
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
057005465ILMDOccupational Therapy Assistant

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Occupational Therapy Assistant 224Z00000X 057005465 IL Yes

Addresses

Primary practice location

304 SW 12TH St
Aledo, IL 61231-2707

Mailing address

304 SW 12TH Street
Aledo, USA 61231

Other providers in Aledo, IL

All providers in Aledo, IL · Occupational Therapy Assistant in Illinois

Sources for this page

Verify at the official NPI Registry.