Provider Demographics
NPI:1538293204
Name:MAKOWSKI, PEGGY LEE (COTA)
Entity Type:Individual
Prefix:MRS
First Name:PEGGY
Middle Name:LEE
Last Name:MAKOWSKI
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 1:90 PRIVATE ROAD 931
Mailing Address - Street 2:
Mailing Address - City:RICHLAND SPRINGS
Mailing Address - State:TX
Mailing Address - Zip Code:76871-8815
Mailing Address - Country:US
Mailing Address - Phone:940-872-7354
Mailing Address - Fax:
Practice Address - Street 1:3001 S JACKSON ST
Practice Address - Street 2:
Practice Address - City:SAN ANGELO
Practice Address - State:TX
Practice Address - Zip Code:76904-5129
Practice Address - Country:US
Practice Address - Phone:325-223-6320
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-15
Last Update Date:2015-08-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX208514224Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes224Z00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapy Assistant