Laura Mackenzie Livengood, COTA
Individual provider Active NPI Occupational Therapy Assistant · Brocton, NY
NPI 1245909464 · NPPES record last updated Sep 10, 2021
Key facts
- NPI
- 1245909464
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Occupational Therapy Assistant 224Z00000X
- License
- 010795 (NY)
- Practice address
- 138 W Main St
Brocton, NY 14716-9749 - Phone
- (716) 792-2100
- NPI assigned
- Sep 10, 2021
- Sex
- Female
- Sole proprietor
- Yes
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Occupational Therapy Assistant | 224Z00000X | 010795 | NY | Yes |
Addresses
Primary practice location
138 W Main St
Brocton, NY 14716-9749
Mailing address
185 Clyde Ave
Jamestown, NY 14701-1767
Phone (716) 720-1573
Other providers in Brocton, NY
- Patricia Elizabeth Dugan
- Rebecca Ann Giambra
- Donald Dwight Hellert
- Nabil Mossad Khalil
- Sara Klepfer
- Claudia Anne Monroe
- Laura Lynn Neratko
- Surendra Pattathan
- Laura Shelters
- Mia Rose Simoncelli
All providers in Brocton, NY · Occupational Therapy Assistant in New York
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Sep 10, 2021. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.