Provider Demographics
NPI:1326292103
Name:NIGBOR, KAY M (COTA)
Entity Type:Individual
Prefix:MRS
First Name:KAY
Middle Name:M
Last Name:NIGBOR
Suffix:
Gender:F
Credentials:COTA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:W7444 DUCK CREEK AVE
Mailing Address - Street 2:
Mailing Address - City:WESTFIELD
Mailing Address - State:WI
Mailing Address - Zip Code:53964-7923
Mailing Address - Country:US
Mailing Address - Phone:608-296-2285
Mailing Address - Fax:608-297-4991
Practice Address - Street 1:626 E SLIFER ST
Practice Address - Street 2:
Practice Address - City:PORTAGE
Practice Address - State:WI
Practice Address - Zip Code:53901-1224
Practice Address - Country:US
Practice Address - Phone:800-862-3725
Practice Address - Fax:608-742-2384
Is Sole Proprietor?:No
Enumeration Date:2008-11-06
Last Update Date:2008-11-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI874-027224Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes224Z00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapy Assistant