Provider Demographics
NPI:1902649171
Name:KASPER, PAULA MARIE (COTA/L)
Entity type:Individual
Prefix:
First Name:PAULA
Middle Name:MARIE
Last Name:KASPER
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 1:17242 N DESERT GLEN DR
Mailing Address - Street 2:
Mailing Address - City:SUN CITY WEST
Mailing Address - State:AZ
Mailing Address - Zip Code:85375-5124
Mailing Address - Country:US
Mailing Address - Phone:507-440-3782
Mailing Address - Fax:
Practice Address - Street 1:17242 N DESERT GLEN DR
Practice Address - Street 2:
Practice Address - City:SUN CITY WEST
Practice Address - State:AZ
Practice Address - Zip Code:85375-5124
Practice Address - Country:US
Practice Address - Phone:507-440-3782
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-06-17
Last Update Date:2024-06-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ047188224Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes224Z00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapy Assistant