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General NPI Number Information
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NPI Number | 1548851520
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Entity Type | Organization
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Legal Business Name | OPTIMAL THERAPY ASSOCIATES SERVICES
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Dates
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Enumeration Date | 02/01/2021
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Last Update Date | 02/01/2021
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Provider Practice Location Address
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Address Line | 365 DUPONT AVE
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City | TONAWANDA
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State | NY
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Zip | 14150-7833
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Country | US
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Telephone | 716-874-8423
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Fax |
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Provider Business Mailing Address
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Address Line | 8992 CALPIN PKWY
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City | CLARENCE CENTER
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State | NY
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Zip | 14032-9551
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | OCCUPATIONAL THERAPY
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Name | NICOLE REED
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Credential | COTA
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Telephone | 469-673-6947
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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 |
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License Number State |
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