MEDICARE: NOEMY VALENCIA OTA/COTA

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	224Z00000X	Occupational Therapy Assistant		NV

General Provider Information

NPI Number	:	1285407437
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	NOEMY VALENCIA OTA/COTA

Provider Business Mailing Address
First Line	:	697 RIATA WAY
Second Line	:
City	:	LAS VEGAS
State	:	NV
Zip	:	89110-3726
Country	:	US
Telephone Number	:	702-690-8211
Fax Number	:

Provider Business Practice Location Address
First Line	:	5155 BLUE DIAMOND RD STE 102
Second Line	:
City	:	LAS VEGAS
State	:	NV
Zip	:	89139-7698
Country	:	US
Telephone Number	:	702-530-2532
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	10/31/2023
Last Update Date	:	10/31/2023

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Directions to “ NOEMY VALENCIA OTA/COTA” Practice Location

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