Individual
JENNIE COIC
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
COTA/L
Contact information
Practice address
23 ODONNALL AVE, ELMA, WA 98541-9429
(360) 470-4220
Mailing address
23 ODONNALL AVE, ELMA, WA 98541-9429
Taxonomy
Speciality
Code
Description
License number
State
224Z00000X
Occupational Therapy Assistant
Primary
OC60402640
WA
Other
Enumeration date
05/20/2015
Last updated
05/20/2015
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