Provider Demographics
NPI:1528213733
Name:NOVOTNY, DIANA LYNNE (COTA/L)
Entity Type:Individual
Prefix:MRS
First Name:DIANA
Middle Name:LYNNE
Last Name:NOVOTNY
Suffix:
Gender:F
Credentials:COTA/L
Other - Prefix:MS
Other - First Name:DIANA
Other - Middle Name:LYNNE
Other - Last Name:SHARP
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:COTA/L
Mailing Address - Street 1:2750 COUNTY ROAD A
Mailing Address - Street 2:
Mailing Address - City:VALPARAISO
Mailing Address - State:NE
Mailing Address - Zip Code:68065
Mailing Address - Country:US
Mailing Address - Phone:402-784-6864
Mailing Address - Fax:
Practice Address - Street 1:646 EAST I
Practice Address - Street 2:
Practice Address - City:DAVID CITY
Practice Address - State:NE
Practice Address - Zip Code:68632
Practice Address - Country:US
Practice Address - Phone:402-367-3045
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2008-12-02
Last Update Date:2008-12-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NE64224Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes224Z00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapy Assistant