Healthcare Provider Details

I. General information

NPI: 1558494948
Provider Name (Legal Business Name): JENNIFER ANN SNYDER COTA
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/14/2007
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

955 GARDEN LAKE PKWY
TOLEDO OH
43614-2777
US

IV. Provider business mailing address

5639 ARMADA DR
TOLEDO OH
43623-1711
US

V. Phone/Fax

Practice location:
  • Phone: 419-382-2200
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code224Z00000X
TaxonomyOccupational Therapy Assistant
License NumberOTA03596
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: