Provider Demographics
NPI:1871077990
Name:BOLLINI, KARLI ANNE (COTA/L)
Entity type:Individual
Prefix:MISS
First Name:KARLI
Middle Name:ANNE
Last Name:BOLLINI
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 1:203 SCHILLER AVE
Mailing Address - Street 2:
Mailing Address - City:SANDUSKY
Mailing Address - State:OH
Mailing Address - Zip Code:44870-6932
Mailing Address - Country:US
Mailing Address - Phone:419-366-9266
Mailing Address - Fax:
Practice Address - Street 1:101 AUXILIARY DR
Practice Address - Street 2:
Practice Address - City:BELLEVUE
Practice Address - State:OH
Practice Address - Zip Code:44811-9492
Practice Address - Country:US
Practice Address - Phone:419-483-5000
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-09-25
Last Update Date:2018-09-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHOTA007379224Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes224Z00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapy Assistant