Provider Demographics
NPI:1922889625
Name:HENSLEY, GENIE (COTA/L)
Entity Type:Individual
Prefix:
First Name:GENIE
Middle Name:
Last Name:HENSLEY
Suffix:
Gender:F
Credentials:COTA/L
Other - Prefix:
Other - First Name:GENIE
Other - Middle Name:
Other - Last Name:CHAPMAN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:PO BOX 726
Mailing Address - Street 2:
Mailing Address - City:MILLS
Mailing Address - State:WY
Mailing Address - Zip Code:82644-0726
Mailing Address - Country:US
Mailing Address - Phone:307-749-3236
Mailing Address - Fax:949-404-6346
Practice Address - Street 1:3905 TEN MILE RD
Practice Address - Street 2:
Practice Address - City:CASPER
Practice Address - State:WY
Practice Address - Zip Code:82604-2894
Practice Address - Country:US
Practice Address - Phone:307-267-7416
Practice Address - Fax:949-404-6346
Is Sole Proprietor?:Yes
Enumeration Date:2023-10-09
Last Update Date:2023-10-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WYOTA-1238225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist