Provider Demographics
NPI:1659811875
Name:DEJOIE, AIMEE MARIANNE (OTR/L)
Entity Type:Individual
Prefix:
First Name:AIMEE
Middle Name:MARIANNE
Last Name:DEJOIE
Suffix:
Gender:F
Credentials:OTR/L
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2800 SAINT PAUL DR APT 259
Mailing Address - Street 2:
Mailing Address - City:SANTA ROSA
Mailing Address - State:CA
Mailing Address - Zip Code:95405-8512
Mailing Address - Country:US
Mailing Address - Phone:707-703-7513
Mailing Address - Fax:
Practice Address - Street 1:2800 SAINT PAUL DR APT 259
Practice Address - Street 2:
Practice Address - City:SANTA ROSA
Practice Address - State:CA
Practice Address - Zip Code:95405-8512
Practice Address - Country:US
Practice Address - Phone:707-703-7513
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2017-03-07
Last Update Date:2017-03-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAOT 9022225X00000X
FLOT 14157225X00000X
NY006232-1225X00000X
COOT.0003713225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist