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General NPI Number Information
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NPI Number | 1508356494
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Entity Type | Individual
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Provider Name | MEGHAN LYNN MCCLOSKEY COTA
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Gender | Female
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Dates
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Enumeration Date | 05/16/2018
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Last Update Date | 05/16/2018
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Provider Practice Location Address
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Address Line | 560 N EXPOSITION ST
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City | WICHITA
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State | KS
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Zip | 67203-5902
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Country | US
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Telephone | 316-618-1252
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Fax | 316-869-2277
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Provider Business Mailing Address
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Address Line | 16119 SKYLINE DR
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City | CLEARWATER
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State | KS
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Zip | 67026-9175
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Country | US
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Telephone | 316-218-7838
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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 | 18-01498
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License Number State | KS
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