Provider Demographics
NPI:1942877394
Name:SCHAFER, MIKAYLA MARIE (COTA/L)
Entity Type:Individual
Prefix:
First Name:MIKAYLA
Middle Name:MARIE
Last Name:SCHAFER
Suffix:
Gender:F
Credentials:COTA/L
Other - Prefix:
Other - First Name:MIKAYLA
Other - Middle Name:MARIE
Other - Last Name:NUNEZ
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:COTA/L
Mailing Address - Street 1:618 SW 8TH ST
Mailing Address - Street 2:
Mailing Address - City:GENEVA
Mailing Address - State:NE
Mailing Address - Zip Code:68361-2811
Mailing Address - Country:US
Mailing Address - Phone:402-300-0597
Mailing Address - Fax:
Practice Address - Street 1:501 N 13TH ST
Practice Address - Street 2:
Practice Address - City:GENEVA
Practice Address - State:NE
Practice Address - Zip Code:68361-1549
Practice Address - Country:US
Practice Address - Phone:402-759-3194
Practice Address - Fax:402-759-3140
Is Sole Proprietor?:No
Enumeration Date:2021-06-04
Last Update Date:2021-06-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NE1048224Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes224Z00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapy Assistant