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NPI Code Detail

MEDICARE: ROBERTA REBECCA HODGIN COTA/L

MEDICARE: ROBERTA REBECCA HODGIN 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 Assistant32000783AIN

General Provider Information

NPI Number : 1598928970
Entity Type Code : Individual
Provider Name (Legal Business Name) : ROBERTA REBECCA HODGIN COTA/L
Provider Business Mailing Address
First Line : 1901 S PARK RD APT A201
Second Line :
City : KOKOMO
State : IN
Zip : 46902-6153
Country : US
Telephone Number : 765-455-3712
Fax Number :
Provider Business Practice Location Address
First Line : 429 W LINCOLN RD
Second Line :
City : KOKOMO
State : IN
Zip : 46902-3508
Country : US
Telephone Number : 765-453-5600
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 07/07/2008
Last Update Date : 07/07/2008

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