Individual
CAROLINE LEE STEVENS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
COTA/L
Contact information
Practice address
3510 NW ABILENE RD, ANKENY, IA 50023-4878
(515) 963-9815
Mailing address
6904 CAPITOL VIEW CT, JOHNSTON, IA 50131-1235
Taxonomy
Speciality
Code
Description
License number
State
224Z00000X
Occupational Therapy Assistant
Primary
079400
IA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
097400
IOWA BOARD OF PHYSICAL AND OCCUPATIONAL THERAPY
IA
01
—
422674
NBCOT CERTIFICATION
IA
Enumeration date
09/01/2020
Last updated
09/01/2020
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