Individual provider · Type 1 NPI
Andrew Melbon Gultom, COTA
Occupational Therapy Assistant · Banning, CA
Practice location
1065 Driftwood Cir
Banning, CA 92220-6321
Fax (877) 799-9128
Specialties and licenses
| Taxonomy | Code | License |
|---|---|---|
| Occupational Therapy Assistant Primary | 224Z00000X | 1013 (CA) |
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 1518159409
Andrew Melbon Gultom, COTA's National Provider Identifier is 1518159409, issued on Aug 14, 2007. The primary taxonomy on file is Occupational Therapy Assistant (224Z00000X), and the practice location is in Banning, CA. The record was last updated on Aug 14, 2007.