MEDICARE: MISS KIMBERLY ANN HAWKE 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	224Z00000X	Occupational Therapy Assistant	35606	OH

General Provider Information

NPI Number	:	1871544650
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MISS KIMBERLY ANN HAWKE COTA/L

Provider Business Mailing Address
First Line	:	2025 ATKINS AVE
Second Line	:	APT #20
City	:	LAKEWOOD
State	:	OH
Zip	:	44107-5457
Country	:	US
Telephone Number	:	440-570-2877
Fax Number	:

Provider Business Practice Location Address
First Line	:	5520 BROADVIEW RD
Second Line	:
City	:	PARMA
State	:	OH
Zip	:	44134-1605
Country	:	US
Telephone Number	:	216-749-4010
Fax Number	:

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

Provider Enumeration Date	:	05/15/2006
Last Update Date	:	05/03/2026

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