Provider Demographics
NPI:1407162159
Name:PRIESTER, BETSY LYNN (COTA)
Entity Type:Individual
Prefix:MS
First Name:BETSY
Middle Name:LYNN
Last Name:PRIESTER
Suffix:
Gender:F
Credentials:COTA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8435 ROUTE 16N
Mailing Address - Street 2:
Mailing Address - City:FRANKLINVILLE
Mailing Address - State:NY
Mailing Address - Zip Code:14737
Mailing Address - Country:US
Mailing Address - Phone:716-353-1035
Mailing Address - Fax:716-676-9150
Practice Address - Street 1:191 NORTH MAIN STREET
Practice Address - Street 2:
Practice Address - City:WELLSVILLE
Practice Address - State:NY
Practice Address - Zip Code:14895
Practice Address - Country:US
Practice Address - Phone:585-596-4011
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2010-08-19
Last Update Date:2010-08-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY001656-1224Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes224Z00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapy Assistant