Individual
MRS. DIANE BOTMA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
COTA
Contact information
Practice address
12516 MARSH LANDING PKWY, CEDAR LAKE, IN 46303-8554
(219) 794-4524
Mailing address
12516 MARSH LANDING PKWY, CEDAR LAKE, IN 46303-8554
(219) 794-4524
Taxonomy
Speciality
Code
Description
License number
State
224Z00000X
Occupational Therapy Assistant
Primary
057002032
IL
Other
Enumeration date
12/11/2013
Last updated
12/11/2013
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