National Provider Identifier

Tricia Vandewalle, COTA

Tricia Vandewalle, COTA is listed in the NPPES registry with a primary specialty of Occupational Therapy Assistant in Victor, NY and a listed phone number of (585) 924-2707.

NPI 1164173316Victor, NYOccupational Therapy Assistant

Profile Overview

NPI
1164173316
Provider Type
Individual
Primary Specialty
Occupational Therapy Assistant
Enumeration Date
January 10, 2022
Last Updated
January 26, 2023

Practice Location

  • 590 Fishers Station Dr
  • Victor, NY 14564-9744

Phone: (585) 924-2707

Mailing Address

  • 57 Beverly Hts
  • Rochester, NY 14616-4616

Specialties

  • Occupational Therapy Assistant (224Z00000X)
Full Record
NPI
1164173316
Entity Type
Individual
Last Name
Vandewalle
First Name
Tricia
Credential
COTA
Provider Other Last Name
Van De Walle
Provider Other First Name
Tricia
Provider Other Middle Name
L
Provider Other Credential Text
COTA
Provider Other Last Name Type Code
2
Mailing Street Address
57 Beverly Hts
Mailing City
Rochester
Mailing State
NY
Mailing ZIP Code
14616-4616
Mailing Country
US
Practice Street Address
590 Fishers Station Dr
Practice City
Victor
Practice State
NY
Practice ZIP Code
14564-9744
Practice Country
US
Practice Phone
(585) 924-2707
Enumeration Date
January 10, 2022
Last Updated
January 26, 2023
Sex
Female
Sole Proprietor
No
Certification Date
January 26, 2023
updated_by_file
npidata_pfile_20050523-20260308.csv
Taxonomies
Occupational Therapy Assistant (224Z00000X)