Healthcare Provider Details

I. General information

NPI: 1003745548
Provider Name (Legal Business Name): JULIA GRACE PALMER COTA/L
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/19/2026
Last Update Date: 05/19/2026
Certification Date: 05/19/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

100 CARMEL MANOR DR
FORT THOMAS KY
41075-2300
US

IV. Provider business mailing address

2590 MADISON RD
CINCINNATI OH
45208-1132
US

V. Phone/Fax

Practice location:
  • Phone: 859-781-5111
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code224Z00000X
TaxonomyOccupational Therapy Assistant
License Number281795
License Number StateKY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: