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General NPI Number Information
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NPI Number | 1003182759
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Entity Type | Individual
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Provider Name | KATHRYN M BELLOWS COTA/L
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Gender | Female
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Dates
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Enumeration Date | 03/27/2012
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Last Update Date | 03/27/2012
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Provider Practice Location Address
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Address Line | 108 E LAKE ST
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City | WINSTED
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State | CT
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Zip | 06098-1912
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Country | US
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Telephone | 860-379-8591
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Fax |
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Provider Business Mailing Address
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Address Line | 101 GREENVIEW DR
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City | WATERBURY
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State | CT
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Zip | 06708-3931
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Country | US
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Telephone | 203-597-1397
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Fax | 203-597-1397
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 224Z00000X
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Taxonomy Name | Occupational Therapy Assistant
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License Number | 001151
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License Number State | CT
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