Individual
CORTNEY LYNN WIEDEMANN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
COTA/L
Contact information
Practice address
1626 WASHINGTON ST, OLEAN, NY 14760-1935
(716) 372-0594
Mailing address
13000 HAWKS HILL RD, HOLLAND, NY 14080-9769
(716) 249-7193
Taxonomy
Speciality
Code
Description
License number
State
224Z00000X
Occupational Therapy Assistant
Primary
010939-01
NY
Other
Enumeration date
01/11/2022
Last updated
01/11/2022
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