Alina Broski I, COTA/L

Individual provider Active NPI Occupational Therapy Assistant · Chesterton, IN

NPI 1720527765 · NPPES record last updated Feb 22, 2017

Key facts

NPI
1720527765
Entity type
Individual (NPI type 1)
Primary specialty
Occupational Therapy Assistant 224Z00000X
Practice address
1120 S. Calument Road
Suite 3
Chesterton, IN 46304
Phone
(219) 983-9675
NPI assigned
Feb 22, 2017
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

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Occupational Therapy Assistant 224Z00000X Yes

Addresses

Primary practice location

1120 S. Calument Road
Suite 3
Chesterton, IN 46304

Mailing address

125 Ridgeview Dr
Valparaiso, IN 46385-7810
Phone (219) 252-4909

Other providers in Chesterton, IN

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

Sources for this page

Verify at the official NPI Registry.