Provider Demographics
NPI:1477702215
Name:DIEMER, CHRISTY KAY (COTA)
Entity Type:Individual
Prefix:MRS
First Name:CHRISTY
Middle Name:KAY
Last Name:DIEMER
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 1:21545 W AVE
Mailing Address - Street 2:
Mailing Address - City:HAWKEYE
Mailing Address - State:IA
Mailing Address - Zip Code:52147-8293
Mailing Address - Country:US
Mailing Address - Phone:563-429-2100
Mailing Address - Fax:
Practice Address - Street 1:530 S LINN AVE
Practice Address - Street 2:
Practice Address - City:NEW HAMPTON
Practice Address - State:IA
Practice Address - Zip Code:50659-2002
Practice Address - Country:US
Practice Address - Phone:641-394-3151
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-09-17
Last Update Date:2008-09-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IA00074224Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes224Z00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapy Assistant