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General NPI Number Information
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NPI Number | 1326614066
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Entity Type | Individual
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Provider Name | BEN WILLIAM CUDNEY COTA/L
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Gender | Male
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Dates
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Enumeration Date | 06/02/2021
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Last Update Date | 06/02/2021
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Provider Practice Location Address
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Address Line | 3910 RAINBOW BLVD
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City | KANSAS CITY
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State | KS
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Zip | 66103-2946
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Country | US
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Telephone | 785-713-1217
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Fax |
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Provider Business Mailing Address
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Address Line | 2400 W 79TH TER
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City | PRAIRIE VILLAGE
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State | KS
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Zip | 66208-3842
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Country | US
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Telephone |
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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 |
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License Number State |
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