Individual
ASHLEIGH LOUISE GOETZ
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
COTA
Contact information
Practice address
6040 LUTE RD, PORTAGE, IN 46368-5008
(219) 763-6858
(219) 763-4858
Mailing address
310 W GREENWOOD AVE, CROWN POINT, IN 46307-4332
(219) 671-0417
(219) 763-4858
Taxonomy
Speciality
Code
Description
License number
State
224Z00000X
Occupational Therapy Assistant
Primary
32001605A
IN
Other
Enumeration date
05/12/2008
Last updated
05/12/2008
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