MEDICARE: MILLIE ENTRIKIN COTA/L

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	224Z00000X	Occupational Therapy Assistant	OTA008820	OH

General Provider Information

NPI Number	:	1356284525
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MILLIE ENTRIKIN COTA/L

Provider Business Mailing Address
First Line	:	12849 MOGADORE AVE NW
Second Line	:
City	:	UNIONTOWN
State	:	OH
Zip	:	44685-9441
Country	:	US
Telephone Number	:	330-488-5178
Fax Number	:

Provider Business Practice Location Address
First Line	:	1951 OH-59 SUITE C
Second Line	:
City	:	KENT
State	:	OH
Zip	:	44240-7133
Country	:	US
Telephone Number	:	330-846-1800
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	04/13/2026
Last Update Date	:	04/13/2026

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Directions to “ MILLIE ENTRIKIN COTA/L” Practice Location

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