Provider Demographics
NPI:1659003424
Name:BRETZ, JOY (COTA)
Entity Type:Individual
Prefix:
First Name:JOY
Middle Name:
Last Name:BRETZ
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 1:30 E ADAMS ST APT 1106
Mailing Address - Street 2:
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60603-5648
Mailing Address - Country:US
Mailing Address - Phone:864-706-3902
Mailing Address - Fax:
Practice Address - Street 1:1366 W FULLERTON AVE
Practice Address - Street 2:
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60614-2129
Practice Address - Country:US
Practice Address - Phone:773-248-9300
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-06-29
Last Update Date:2022-06-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes224Z00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapy Assistant