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General NPI Number Information
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NPI Number | 1063392264
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Entity Type | Individual
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Provider Name | ELLA JAYNE HYLAND COTA/L
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Gender | Female
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Dates
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Enumeration Date | 09/08/2025
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Last Update Date | 09/08/2025
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Provider Practice Location Address
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Address Line | 170 US ROUTE 1 STE 100
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City | FALMOUTH
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State | ME
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Zip | 04105-2152
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Country | US
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Telephone | 207-781-0022
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Fax | 207-781-0025
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Provider Business Mailing Address
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Address Line | 71 N MARRINER ST
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City | SOUTH PORTLAND
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State | ME
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Zip | 04106-2015
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Country | US
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Telephone | 207-210-2284
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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 | OA4868
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License Number State | ME
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