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NPI Code Detail

MEDICARE: MRS. REBECCA GAY TROGDEN COTA/L

MEDICARE: MRS. REBECCA GAY TROGDEN COTA/L
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1224Z00000XOccupational Therapy AssistantA2679KY

General Provider Information

NPI Number : 1619211026
Entity Type Code : Individual
Provider Name (Legal Business Name) : MRS. REBECCA GAY TROGDEN COTA/L
Provider Business Mailing Address
First Line : 8005 US HIGHWAY 60 W
Second Line :
City : LEWISPORT
State : KY
Zip : 42351-7079
Country : US
Telephone Number : 270-295-6756
Fax Number : 270-295-3759
Provider Business Practice Location Address
First Line : 8005 US HIGHWAY 60 W
Second Line :
City : LEWISPORT
State : KY
Zip : 42351-7079
Country : US
Telephone Number : 270-295-6756
Fax Number : 270-295-3759
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 11/26/2012
Last Update Date : 11/26/2012

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