Provider Demographics
NPI:1710138458
Name:FINK, BETH ELLEN (COTA/L)
Entity Type:Individual
Prefix:MISS
First Name:BETH
Middle Name:ELLEN
Last Name:FINK
Suffix:
Gender:F
Credentials:COTA/L
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7920 NW 50TH ST APT 202
Mailing Address - Street 2:
Mailing Address - City:LAUDERHILL
Mailing Address - State:FL
Mailing Address - Zip Code:33351-5672
Mailing Address - Country:US
Mailing Address - Phone:954-770-1314
Mailing Address - Fax:
Practice Address - Street 1:1870 PISQAH RD
Practice Address - Street 2:
Practice Address - City:HENDERSONVILL
Practice Address - State:NC
Practice Address - Zip Code:28739
Practice Address - Country:US
Practice Address - Phone:828-693-9796
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2008-09-30
Last Update Date:2008-09-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC6949224Z00000X
FLOTA10125224Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes224Z00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapy Assistant