Healthcare Provider Details

I. General information

NPI: 1528876919
Provider Name (Legal Business Name): RACHEL ELIZABETH WYSONG-WARD COTA
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 12/18/2024
Last Update Date: 12/18/2024
Certification Date: 12/18/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7591 TYLERS PLACE BLVD
WEST CHESTER OH
45069-6308
US

IV. Provider business mailing address

7591 TYLERS PLACE BLVD
WEST CHESTER OH
45069-6308
US

V. Phone/Fax

Practice location:
  • Phone: 513-755-6600
  • Fax:
Mailing address:
  • Phone: 513-755-6600
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code224Z00000X
TaxonomyOccupational Therapy Assistant
License NumberOTA008221
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: