Simon Wise, Cota
Occupational Therapy Assistant, Feeding, Eating & Swallowing in Flourtown, PA. Individual provider (NPI-1).
NPI number1083170062
StatusActive
Last updated in NPPESFeb 14, 2019
Details
- NPI
- 1083170062
- Entity type
- Individual (NPI-1)
- Name
- Simon Wise
- Credential
- Cota
- Sex
- Male
- Sole proprietor
- Yes
- Enumeration date
- Feb 14, 2019
- Last updated
- Feb 14, 2019
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 224ZF0002X | Occupational Therapy Assistant, Feeding, Eating & Swallowing | – | – | Yes |
Practice location
110 W Wissahickon AveFlourtown, PA 19031-1802
Phone 215-836-4179
Mailing address
17 Stevens CtSomerdale, NJ 08083-3007
Phone 469-396-3214
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