Provider Demographics
NPI:1467667352
Name:ISLEY, BECKY SUE (COTA/L)
Entity Type:Individual
Prefix:MRS
First Name:BECKY
Middle Name:SUE
Last Name:ISLEY
Suffix:
Gender:F
Credentials:COTA/L
Other - Prefix:MRS
Other - First Name:BECKY
Other - Middle Name:SUE
Other - Last Name:WEBBY
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:COTA/L
Mailing Address - Street 1:1020 ELM ST
Mailing Address - Street 2:
Mailing Address - City:PROSSER
Mailing Address - State:WA
Mailing Address - Zip Code:99350-1016
Mailing Address - Country:US
Mailing Address - Phone:509-786-1066
Mailing Address - Fax:
Practice Address - Street 1:721 OTIS AVE
Practice Address - Street 2:
Practice Address - City:SUNNYSIDE
Practice Address - State:WA
Practice Address - Zip Code:98944-2328
Practice Address - Country:US
Practice Address - Phone:509-837-2122
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-05-14
Last Update Date:2009-06-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAOCOOOOO822224Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes224Z00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapy Assistant