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General NPI Number Information
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NPI Number | 1962746412
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Entity Type | Individual
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Provider Name | REBECCA ANN MOORE COTA/L
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Gender | Female
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Dates
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Enumeration Date | 11/22/2012
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Last Update Date | 11/22/2012
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Provider Practice Location Address
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Address Line | 476 RIDDLE RD
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City | CINCINNATI
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State | OH
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Zip | 45220-2411
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Country | US
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Telephone | 513-281-8001
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Fax |
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Provider Business Mailing Address
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Address Line | 3347 STEVIE LN
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City | CINCINNATI
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State | OH
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Zip | 45239-6221
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Country | US
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Telephone |
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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 | 04947
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License Number State | OH
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