MEDICARE: HILDY JANE MOHLER 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	224ZE0001X	Environmental Modification Occupational Therapy Assistant	210450	TX

General Provider Information

NPI Number	:	1487921953
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	HILDY JANE MOHLER COTA/L

Provider Business Mailing Address
First Line	:	6915 AUTUMN RAIN LN
Second Line	:
City	:	SPRING
State	:	TX
Zip	:	77379-8463
Country	:	US
Telephone Number	:	832-229-2724
Fax Number	:

Provider Business Practice Location Address
First Line	:	8580 WOODWAY DR
Second Line	:
City	:	HOUSTON
State	:	TX
Zip	:	77063-2423
Country	:	US
Telephone Number	:	713-781-0645
Fax Number	:

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

Provider Enumeration Date	:	11/28/2011
Last Update Date	:	11/28/2011

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