Provider Demographics
NPI:1346475985
Name:VEST, CASEY JOLENE (COTA/L)
Entity Type:Individual
Prefix:MS
First Name:CASEY
Middle Name:JOLENE
Last Name:VEST
Suffix:
Gender:F
Credentials:COTA/L
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:RT 92 @ RT 60
Mailing Address - Street 2:
Mailing Address - City:WHITE SULPHUR SPRINGS
Mailing Address - State:WV
Mailing Address - Zip Code:24986
Mailing Address - Country:US
Mailing Address - Phone:304-536-4661
Mailing Address - Fax:304-536-1328
Practice Address - Street 1:1218 POCAHONTAS AVE
Practice Address - Street 2:
Practice Address - City:RONCEVERTE
Practice Address - State:WV
Practice Address - Zip Code:24970-1025
Practice Address - Country:US
Practice Address - Phone:304-661-7151
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2009-05-27
Last Update Date:2009-05-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WVC1637224Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes224Z00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapy Assistant