Provider Demographics
NPI:1033778683
Name:KOKMEYER, GAYLE NAOMI (OTR/L)
Entity Type:Individual
Prefix:
First Name:GAYLE
Middle Name:NAOMI
Last Name:KOKMEYER
Suffix:
Gender:F
Credentials:OTR/L
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:820 JOHN ST STE 104
Mailing Address - Street 2:
Mailing Address - City:KALAMAZOO
Mailing Address - State:MI
Mailing Address - Zip Code:49001-2836
Mailing Address - Country:US
Mailing Address - Phone:269-341-8025
Mailing Address - Fax:269-341-6511
Practice Address - Street 1:820 JOHN ST STE 104
Practice Address - Street 2:
Practice Address - City:KALAMAZOO
Practice Address - State:MI
Practice Address - Zip Code:49001-2836
Practice Address - Country:US
Practice Address - Phone:269-341-8025
Practice Address - Fax:269-341-6511
Is Sole Proprietor?:No
Enumeration Date:2019-06-07
Last Update Date:2019-06-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI5201001785225XP0019X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225XP0019XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistPhysical Rehabilitation