Provider Demographics
NPI:1841516515
Name:EMLEY, KRISTIN LYN (COTA)
Entity type:Individual
Prefix:
First Name:KRISTIN
Middle Name:LYN
Last Name:EMLEY
Suffix:
Gender:F
Credentials:COTA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
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Other - Credentials:
Mailing Address - Street 1:44 BERG LN
Mailing Address - Street 2:
Mailing Address - City:FREWSBURG
Mailing Address - State:NY
Mailing Address - Zip Code:14738-9588
Mailing Address - Country:US
Mailing Address - Phone:716-488-2322
Mailing Address - Fax:716-488-2574
Practice Address - Street 1:50 IROQUOIS DR
Practice Address - Street 2:
Practice Address - City:SALAMANCA
Practice Address - State:NY
Practice Address - Zip Code:14779-1361
Practice Address - Country:US
Practice Address - Phone:716-945-2400
Practice Address - Fax:719-945-3964
Is Sole Proprietor?:No
Enumeration Date:2010-04-20
Last Update Date:2012-09-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY004914-1224Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes224Z00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapy Assistant