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Individual

MRS. AMY B KUPSTAS

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
COTA/L

Contact information

Practice address
11850 NICHOLAS ST STE 100, OMAHA, NE 68154-4476
(402) 505-4670
Mailing address
55 YATES ST, FORTY FORT, PA 18704-4118
(570) 690-0623

Taxonomy

Speciality
Code
Description
License number
State
224Z00000X
Occupational Therapy Assistant
Primary
OP006778
PA

Other

Enumeration date
04/28/2011
Last updated
04/28/2011
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