Individual
MISS ANDI KATELYN OTTO
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
COTA
Contact information
Practice address
5400 LAUREL LAKE DR, WACO, TX 76710-2835
(254) 774-4644
Mailing address
4578 LEROY PKWY, ELM MOTT, TX 76640-3551
Taxonomy
Speciality
Code
Description
License number
State
224Z00000X
Occupational Therapy Assistant
Primary
214-510
TX
Other
Enumeration date
06/18/2018
Last updated
06/18/2018
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