Healthcare Provider Details

I. General information

NPI: 1861724262
Provider Name (Legal Business Name): JULIE M MOATS COTA/L
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 02/10/2010
Last Update Date: 03/10/2025
Certification Date: 03/10/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2484 W STATE ST
ALLIANCE OH
44601-5608
US

IV. Provider business mailing address

144 E MILTON ST
ALLIANCE OH
44601-5076
US

V. Phone/Fax

Practice location:
  • Phone: 330-867-2240
  • Fax:
Mailing address:
  • Phone: 330-614-6546
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code224Z00000X
TaxonomyOccupational Therapy Assistant
License NumberOTA 4313
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: