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NPI Code Detail

MEDICARE: MISS WANDA A HAYES COTAL

MEDICARE: MISS WANDA A HAYES COTAL
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 AssistantOTA00627OH

General Provider Information

NPI Number : 1851426373
Entity Type Code : Individual
Provider Name (Legal Business Name) : MISS WANDA A HAYES COTAL
Provider Business Mailing Address
First Line : 1874 WYMORE AVE
Second Line :
City : EAST CLEVELAND
State : OH
Zip : 44112-3914
Country : US
Telephone Number : 216-541-3611
Fax Number :
Provider Business Practice Location Address
First Line : 1275 LAKESIDE AVE E
Second Line :
City : CLEVELAND
State : OH
Zip : 44114-1132
Country : US
Telephone Number : 216-241-8320
Fax Number : 216-861-0253
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 02/23/2007
Last Update Date : 07/08/2007

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Directions to “ MISS WANDA A HAYES COTAL” Practice Location

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