Bonnie Rudy, OTR/L

Individual provider Active NPI Pediatric Occupational Therapist · Mountain View, WY

NPI 1619691979 · NPPES record last updated Sep 30, 2022

Key facts

NPI
1619691979
Entity type
Individual (NPI type 1)
Primary specialty
Pediatric Occupational Therapist 225XP0200X
License
OT-702 (WY)
Practice address
3100 County Road 241
Mountain View, WY 82939
Phone
(307) 782-6202
NPI assigned
Sep 30, 2022
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

State licenses

LicenseStateTypeSpecialty
OT-702WYMDPediatric Occupational Therapist

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatric Occupational Therapist 225XP0200X OT-702 WY Yes

Addresses

Primary practice location

3100 County Road 241
Mountain View, WY 82939

Mailing address

PO Box 321
Mountain View, WY 82939-0321
Phone (307) 747-0494

Other providers in Mountain View, WY

All providers in Mountain View, WY · Pediatric Occupational Therapist in Wyoming

Sources for this page

Verify at the official NPI Registry.