Provider Demographics
NPI:1053937516
Name:WIONCEK, AIDA COKA (MOT, OTR/L)
Entity type:Individual
Prefix:
First Name:AIDA
Middle Name:COKA
Last Name:WIONCEK
Suffix:
Gender:F
Credentials:MOT, OTR/L
Other - Prefix:
Other - First Name:AIDA
Other - Middle Name:
Other - Last Name:COKA
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MOT, OTR/L
Mailing Address - Street 1:9368 N LILLEY RD
Mailing Address - Street 2:
Mailing Address - City:PLYMOUTH
Mailing Address - State:MI
Mailing Address - Zip Code:48170-4610
Mailing Address - Country:US
Mailing Address - Phone:734-416-3900
Mailing Address - Fax:734-453-2118
Practice Address - Street 1:29460 FORD RD
Practice Address - Street 2:
Practice Address - City:GARDEN CITY
Practice Address - State:MI
Practice Address - Zip Code:48135-2318
Practice Address - Country:US
Practice Address - Phone:734-522-0065
Practice Address - Fax:734-522-0068
Is Sole Proprietor?:No
Enumeration Date:2020-06-21
Last Update Date:2022-09-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI5201010900225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist