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General NPI Number Information
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NPI Number | 1063223733
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Entity Type | Individual
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Provider Name | KATHLEEN ANN CASSINO COTA/L
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Gender | Female
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Dates
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Enumeration Date | 01/14/2025
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Last Update Date | 01/14/2025
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Provider Practice Location Address
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Address Line | 10 RHODES AVE
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City | NORTH SMITHFIELD
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State | RI
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Zip | 02896-6987
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Country | US
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Telephone | 401-767-3500
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Fax |
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Provider Business Mailing Address
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Address Line | 16 ATWOOD AVE
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City | NORTH PROVIDENCE
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State | RI
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Zip | 02904-3605
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Country | US
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Telephone | 401-222-9733
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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 | OTA00519
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License Number State | RI
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