Individual provider · Type 1 NPI
Madilyn Grace Lack, COTA/L
Occupational Therapy Assistant · Gatewood, MO
Practice location
11111 State Highway 142W
Gatewood, MO 63942-7619
Mailing address
109 Muskrat Ln
Doniphan, MO 63935-6502
Specialties and licenses
| Taxonomy | Code | License |
|---|---|---|
| Occupational Therapy Assistant Primary | 224Z00000X | 2026029031 (MO) |
Occupational Therapy Assistant: An occupational therapy assistant is a person who has graduated from an occupational therapy assistant program accredited by the Accreditation Council for Occupational Therapy Education (ACOTE) or predecessor organizations, has successfully completed a period of supervised fieldwork experience required by the accredited occupational therapy assistant program, has passed a nationally recognized entry-level examinatio…
About NPI 1134041148
Madilyn Grace Lack, COTA/L's National Provider Identifier is 1134041148, issued on Jul 29, 2026. The primary taxonomy on file is Occupational Therapy Assistant (224Z00000X), and the practice location is in Gatewood, MO. The record was last updated on Jul 29, 2026.