=====================================================
General NPI Number Information
=====================================================
NPI Number | 1336584580
-----------------------------------------------------
Entity Type | Individual
-----------------------------------------------------
Provider Name | RACHEAL D SAINATO COTA/L
-----------------------------------------------------
Gender | Female
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 05/01/2013
-----------------------------------------------------
Last Update Date | 05/01/2013
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 460 S COLLEGE ST HOPKINS CENTER
-----------------------------------------------------
City | WOODBURN
-----------------------------------------------------
State | KY
-----------------------------------------------------
Zip | 42170-9638
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 270-529-2853
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 4645 US HIGHWAY 62 W
-----------------------------------------------------
City | GREENVILLE
-----------------------------------------------------
State | KY
-----------------------------------------------------
Zip | 42345-4475
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 270-977-9979
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position |
-----------------------------------------------------
Name |
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone |
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 224Z00000X
-----------------------------------------------------
Taxonomy Name | Occupational Therapy Assistant
-----------------------------------------------------
License Number | A5508
-----------------------------------------------------
License Number State | KY
-----------------------------------------------------