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1023550662
KAITLYN DIEDRICH
AFTON, WY
NPI
1023550662
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Entity Type
Individual
Gender
Female
Sole Proprietor ?
No
Primary Taxonomy
224Z00000X Occupational Therapy Assistant
(Licence: WY COTA-1177)
Enumeration Date
2016-11-14
Last Update Date
2016-11-14
Business Address
-- KAITLYN DIEDRICH COTA
675 WASHINGTON
AFTON, WY 83110
Phone number: 307-885-9286
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Mailing Address
-- KAITLYN DIEDRICH COTA
PO BOX 570
MOUNTAIN VIEW, WY 82939-0570
Phone number: 307-782-6602
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