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General NPI Number Information
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NPI Number | 1861830473
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Entity Type | Individual
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Provider Name | TRISHA D GOSS COTA/L
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Gender | Female
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Dates
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Enumeration Date | 06/06/2013
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Last Update Date | 02/19/2016
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Provider Practice Location Address
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Address Line | 122 SLOCUM RD
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City | HEBRON
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State | CT
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Zip | 06248-1437
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Country | US
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Telephone | 614-623-3571
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Fax |
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Provider Business Mailing Address
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Address Line | 122 SLOCUM RD
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City | HEBRON
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State | CT
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Zip | 06248-1437
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Country | US
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Telephone | 860-455-3736
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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 | 251E00000X
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Taxonomy Name | Home Health Agency
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License Number | 224
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License Number State | CT
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Taxonomy #2
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Taxonomy Code | 282N00000X
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Taxonomy Name | General Acute Care Hospital
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License Number | 224
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License Number State | CT
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Taxonomy #3
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Taxonomy Code | 310400000X
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Taxonomy Name | Assisted Living Facility
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License Number | 224
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License Number State | CT
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Taxonomy #4
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Taxonomy Code | 314000000X
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Taxonomy Name | Skilled Nursing Facility
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License Number | 224
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License Number State | CT
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Taxonomy #5
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Taxonomy Code | 225X00000X
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Taxonomy Name | Occupational Therapist
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License Number | 224
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License Number State | CT
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Taxonomy #6
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Taxonomy Code | 225XP0200X
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Taxonomy Name | Pediatric Occupational Therapist
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License Number | 224
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License Number State | CT
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