Healthcare Provider Details

I. General information

NPI: 1619269438
Provider Name (Legal Business Name): RACHEL ANDERSON COTA/L
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/12/2011
Last Update Date: 10/07/2026
Certification Date: 10/07/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2308 WADE AVE
ASHTABULA OH
44004-9435
US

IV. Provider business mailing address

2308 WADE AVE
ASHTABULA OH
44004-9435
US

V. Phone/Fax

Practice location:
  • Phone: 440-993-2500
  • Fax:
Mailing address:
  • Phone: 440-993-2500
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code224Z00000X
TaxonomyOccupational Therapy Assistant
License NumberOTA004605
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: