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NPI Code Detail

MEDICARE: MARIAH DOLBOW COTA/L

MEDICARE: MARIAH DOLBOW 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 Assistant213974TX
2224Z00000XOccupational Therapy Assistant05959OH

General Provider Information

NPI Number : 1548718992
Entity Type Code : Individual
Provider Name (Legal Business Name) : MARIAH DOLBOW COTA/L
Provider Business Mailing Address
First Line : 921 HUDSON RD
Second Line :
City : KENT
State : OH
Zip : 44240-2111
Country : US
Telephone Number : 330-554-8226
Fax Number :
Provider Business Practice Location Address
First Line : 87 IH 10 N STE 225
Second Line :
City : BEAUMONT
State : TX
Zip : 77707-2549
Country : US
Telephone Number : 409-835-0228
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 09/14/2016
Last Update Date : 09/14/2016

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Directions to “ MARIAH DOLBOW COTA/L” Practice Location

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