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NPI Code Detail

MEDICARE: JESSICA LEANNE DRAYER COTA/L

MEDICARE:   JESSICA LEANNE DRAYER  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
1224Z00000XOccupational Therapy AssistantOTA.03354OH

General Provider Information

NPI Number : 1356518476
Entity Type Code : Individual
Provider Name (Legal Business Name) : JESSICA LEANNE DRAYER COTA/L
Provider Business Mailing Address
First Line : 659 CARLISLE AVE
Second Line :
City : DAYTON
State : OH
Zip : 45410-2736
Country : US
Telephone Number : 937-307-7655
Fax Number :
Provider Business Practice Location Address
First Line : 6276 LONDON PLATTSBURG RD
Second Line :
City : SOUTH CHARLESTON
State : OH
Zip : 45368-8801
Country : US
Telephone Number : 937-408-2829
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 05/08/2008
Last Update Date : 05/08/2008

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Directions to “ JESSICA LEANNE DRAYER COTA/L” Practice Location

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