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NPI Code Detail

MEDICARE: MS. KIMBERLY HOPE YECKE COTA/L

MEDICARE: MS. KIMBERLY HOPE YECKE 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 Assistant5014SC

General Provider Information

NPI Number : 1396376307
Entity Type Code : Individual
Provider Name (Legal Business Name) : MS. KIMBERLY HOPE YECKE COTA/L
Provider Business Mailing Address
First Line : 9221 N MORETO CIR
Second Line :
City : SUMMERVILLE
State : SC
Zip : 29485-8870
Country : US
Telephone Number : 843-475-6699
Fax Number :
Provider Business Practice Location Address
First Line : 672 MARINA DR STE 104
Second Line :
City : CHARLESTON
State : SC
Zip : 29492-9084
Country : US
Telephone Number : 843-475-6699
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 01/29/2020
Last Update Date : 01/29/2020

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