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General NPI Number Information
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NPI Number | 1366016636
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Entity Type | Individual
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Provider Name | ALYSSA MARIE WOJTALEWICZ
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Gender | Female
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Dates
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Enumeration Date | 05/19/2021
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Last Update Date | 09/17/2021
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Provider Practice Location Address
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Address Line | 1405 HERITAGE DR
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City | SAINT PAUL
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State | NE
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Zip | 68873-3618
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Country | US
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Telephone | 308-754-5486
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Fax |
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Provider Business Mailing Address
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Address Line | 1189 JANSEN RD
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City | SAINT PAUL
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State | NE
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Zip | 68873-6843
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Country | US
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Telephone | 402-990-5322
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 224Z00000X
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Taxonomy Name | Occupational Therapy Assistant
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License Number | 1127
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License Number State | NE
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Taxonomy #2
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Taxonomy Code | 224Z00000X
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Taxonomy Name | Occupational Therapy Assistant
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License Number |
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License Number State |
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