Destiny Walesiak, COTA

Primary specialty

Occupational Therapy AssistantTaxonomy code 224Z00000X

License

212171 Issued in TX

Practice address

600 W 3Rd St
Borger, TX 79007-4008

Phone

(806) 274-9856

NPI assigned

Jul 7, 2015

Sex

Female

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1436227200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1436227200000",
    "number": "1760865802",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "314 CORONADO ST",
            "city": "FRITCH",
            "state": "TX",
            "postal_code": "790368162",
            "telephone_number": "806-886-1789"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "600 W 3RD ST",
            "city": "BORGER",
            "state": "TX",
            "postal_code": "790074008",
            "telephone_number": "806-274-9856"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WALESIAK",
        "first_name": "DESTINY",
        "credential": "COTA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2015-07-07",
        "last_updated": "2015-07-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "224Z00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapy Assistant",
            "state": "TX",
            "license": "212171",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Tyler D Tucker, PHARMD
• United Supermarkets LLC
• Melodie Vann, FNP-C
• W.H.Landers, Jr., M.D., PLLC
• Wal-Mart Stores Texas LLC
• Wallace Mann MD PA
• Kami Ware, M.S., CCC-SLP
• Ammon David Weber, MD
• White Deer Isd
• Huzaifa Yasin, DMD

• Occupational Therapy Assistant in Borger, TX
• Providers in Borger, TX by specialty
• Occupational Therapy Assistant in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 7, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.