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NPI Code Detail

MEDICARE: MRS. LAUREN NICHOLE BALL COTA/L

MEDICARE: MRS. LAUREN NICHOLE BALL 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 Assistant239291KY

General Provider Information

NPI Number : 1881840858
Entity Type Code : Individual
Provider Name (Legal Business Name) : MRS. LAUREN NICHOLE BALL COTA/L
Provider Business Mailing Address
First Line : 215 SHAMROCK DR
Second Line :
City : MADISONVILLE
State : KY
Zip : 42431-9176
Country : US
Telephone Number : 270-836-7656
Fax Number :
Provider Business Practice Location Address
First Line : 851 KIMSEY LN
Second Line :
City : HENDERSON
State : KY
Zip : 42420-2665
Country : US
Telephone Number : 270-826-6436
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 08/11/2008
Last Update Date : 08/11/2008

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