MEDICARE: COLLABORATION FOR KIDS

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

General Provider Information

NPI Number	:	1376490953
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	COLLABORATION FOR KIDS

Provider Business Mailing Address
First Line	:	1171 TANGLEWOOD DR
Second Line	:
City	:	GREENWOOD
State	:	IN
Zip	:	46142-5224
Country	:	US
Telephone Number	:	317-881-9923
Fax Number	:

Provider Business Practice Location Address
First Line	:	1171 TANGLEWOOD DR
Second Line	:
City	:	GREENWOOD
State	:	IN
Zip	:	46142-5224
Country	:	US
Telephone Number	:	317-881-9923
Fax Number	:

Authorized Official
Title or Position	:	OCCUPATIONAL THERAPY ASSISTANT
Name	:	COURTNEY DANIELLE DURHAM
Credential	:	COTA
Telephone Number	:	513-550-9862

Provider Enumeration Date	:	03/12/2026
Last Update Date	:	03/12/2026

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