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NPI Code Detail

MEDICARE: KATHRYN GRADY COTA/L

MEDICARE: KATHRYN GRADY 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 Assistant3869CA
2224Z00000XOccupational Therapy Assistant3926AL

General Provider Information

NPI Number : 1437685013
Entity Type Code : Individual
Provider Name (Legal Business Name) : KATHRYN GRADY COTA/L
Provider Business Mailing Address
First Line : 585 NUT TREE CT
Second Line :
City : VACAVILLE
State : CA
Zip : 95687-3353
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 585 NUT TREE CT
Second Line :
City : VACAVILLE
State : CA
Zip : 95687-3353
Country : US
Telephone Number : 707-449-8000
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 05/02/2017
Last Update Date : 05/02/2017

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Directions to “ KATHRYN GRADY COTA/L” Practice Location

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