Provider Demographics
NPI:1154826063
Name:YONIKA, KERI-LYNN MARIE (COTA)
Entity Type:Individual
Prefix:
First Name:KERI-LYNN
Middle Name:MARIE
Last Name:YONIKA
Suffix:
Gender:F
Credentials:COTA
Other - Prefix:MS
Other - First Name:KERI-LYNN
Other - Middle Name:MARIE
Other - Last Name:YONIKA
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:KERI-LYNN YONIKA
Mailing Address - Street 1:9 HAYWOOD AVE
Mailing Address - Street 2:
Mailing Address - City:RUTLAND
Mailing Address - State:VT
Mailing Address - Zip Code:05701-4832
Mailing Address - Country:US
Mailing Address - Phone:802-747-6413
Mailing Address - Fax:
Practice Address - Street 1:9 HAYWOOD AVE
Practice Address - Street 2:
Practice Address - City:RUTLAND
Practice Address - State:VT
Practice Address - Zip Code:05701-4832
Practice Address - Country:US
Practice Address - Phone:802-747-6413
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-03-25
Last Update Date:2018-03-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VT073.0900217224Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes224Z00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapy Assistant