National Provider Identifier

Laura Mackenzie Livengood, COTA

Laura Mackenzie Livengood, COTA is listed in the NPPES registry with a primary specialty of Occupational Therapy Assistant in Brocton, NY and a listed phone number of (716) 792-2100.

NPI 1245909464Brocton, NYOccupational Therapy Assistant

Profile Overview

NPI
1245909464
Provider Type
Individual
Primary Specialty
Occupational Therapy Assistant
Enumeration Date
September 10, 2021
Last Updated
September 10, 2021

Practice Location

  • 138 W Main St
  • Brocton, NY 14716-9749

Phone: (716) 792-2100

Mailing Address

  • 185 Clyde Ave
  • Jamestown, NY 14701-1767

Specialties

  • Occupational Therapy Assistant (224Z00000X)
Full Record
NPI
1245909464
Entity Type
Individual
Last Name
Livengood
First Name
Laura
Middle Name
Mackenzie
Credential
COTA
Mailing Street Address
185 Clyde Ave
Mailing City
Jamestown
Mailing State
NY
Mailing ZIP Code
14701-1767
Mailing Country
US
Mailing Phone
(716) 720-1573
Practice Street Address
138 W Main St
Practice City
Brocton
Practice State
NY
Practice ZIP Code
14716-9749
Practice Country
US
Practice Phone
(716) 792-2100
Enumeration Date
September 10, 2021
Last Updated
September 10, 2021
Sex
Female
Sole Proprietor
Yes
Certification Date
September 10, 2021
updated_by_file
npidata_pfile_20050523-20260308.csv
Taxonomies
Occupational Therapy Assistant (224Z00000X)