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General NPI Number Information
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NPI Number | 1043337645
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Entity Type | Individual
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Provider Name | CHRISTINE MARIE BLUBAUGH COTA
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Gender | Female
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Dates
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Enumeration Date | 03/26/2007
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Last Update Date | 07/08/2007
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Provider Practice Location Address
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Address Line | 435 AVIS AVE NW
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City | MASSILLON
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State | OH
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Zip | 44646-3555
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Country | US
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Telephone | 330-837-1741
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Fax | 330-837-4618
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Provider Business Mailing Address
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Address Line | 1491 W VALENTINE CIR NW
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City | CANTON
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State | OH
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Zip | 44708-3144
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Country | US
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Telephone | 330-455-1452
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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 | OTA 00622
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License Number State | OH
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