Individual provider · Type 1 NPI

Andrew Melbon Gultom, COTA

Occupational Therapy Assistant · Banning, CA

NPI number 1518159409 Active

Practice location

1065 Driftwood Cir
Banning, CA 92220-6321

Fax (877) 799-9128

Specialties and licenses

TaxonomyCodeLicense
Occupational Therapy Assistant Primary 224Z00000X1013 (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.