Provider Demographics
NPI:1811190721
Name:VOLL, ELIZABETH A (COTA)
Entity Type:Individual
Prefix:
First Name:ELIZABETH
Middle Name:A
Last Name:VOLL
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 1:615 SE CRABAPPLE DR
Mailing Address - Street 2:
Mailing Address - City:WAUKEE
Mailing Address - State:IA
Mailing Address - Zip Code:50263-8370
Mailing Address - Country:US
Mailing Address - Phone:515-979-9856
Mailing Address - Fax:
Practice Address - Street 1:615 SE CRABAPPLE DR
Practice Address - Street 2:
Practice Address - City:WAUKEE
Practice Address - State:IA
Practice Address - Zip Code:50263-8370
Practice Address - Country:US
Practice Address - Phone:515-979-9856
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-06-07
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IA00526224Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes224Z00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapy Assistant