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General NPI Number Information
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NPI Number | 1831962539
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Entity Type | Individual
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Provider Name | TAYLOR LORAN KEENE COTA
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Gender | Female
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Dates
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Enumeration Date | 11/03/2023
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Last Update Date | 11/03/2023
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Provider Practice Location Address
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Address Line | 410 FAIR LN
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City | TIFFIN
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State | OH
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Zip | 44883-2518
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Country | US
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Telephone | 419-443-0059
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Fax |
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Provider Business Mailing Address
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Address Line | 3941 GREENWICH MILAN TOWNLINE RD
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City | GREENWICH
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State | OH
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Zip | 44837-9437
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Country | US
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Telephone | 419-951-3176
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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 | 497750
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License Number State | OH
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