Individual
AISLINN MARIE FOGARTY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
COTA
Contact information
Practice address
308 E 3RD ST, LIBBY, MT 59923-2140
(406) 293-6285
Mailing address
6094 W DUNKLIN ST, DUNNELLON, FL 34433-5518
(701) 840-8368
Taxonomy
Speciality
Code
Description
License number
State
224Z00000X
Occupational Therapy Assistant
Primary
OTP-OTA-LIC-9532
MT
Other
Enumeration date
01/25/2023
Last updated
01/25/2023
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