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General NPI Number Information
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NPI Number | 1609775295
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Entity Type | Individual
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Provider Name | CLARISSA SHINDLEDECKER COTA/L
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Gender | Female
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Dates
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Enumeration Date | 11/02/2026
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Last Update Date | 11/02/2026
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Provider Practice Location Address
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Address Line | 924 CHARLIES WAY
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City | MONTPELIER
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State | OH
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Zip | 43543-1904
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Country | US
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Telephone | 419-485-8307
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Fax |
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Provider Business Mailing Address
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Address Line | 2235 STATE ROUTE 191
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City | STRYKER
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State | OH
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Zip | 43557-9442
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Country | US
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Telephone | 419-906-7119
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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 | OTA.04360
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License Number State | OH
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