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General NPI Number Information
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NPI Number | 1003727314
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Entity Type | Individual
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Provider Name | MARJORIE J CARAWAY MAHLE COTA/L
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Gender | Female
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Dates
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Enumeration Date | 09/15/2026
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Last Update Date | 09/15/2026
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Provider Practice Location Address
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Address Line | 425 EDISON BLVD
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City | XENIA
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State | OH
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Zip | 45385-2253
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Country | US
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Telephone | 937-562-9706
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Fax |
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Provider Business Mailing Address
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Address Line | 10300 ALLIANCE RD
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City | BLUE ASH
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State | OH
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Zip | 45242-4734
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Country | US
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Telephone | 513-793-4407
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Fax |
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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 | OTA008112
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License Number State | OH
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