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NPI Code Detail

MEDICARE: ABIGAIL MCQUILLEN COTA/L

MEDICARE: ABIGAIL MCQUILLEN 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 AssistantOTA007566OH

General Provider Information

NPI Number : 1891348413
Entity Type Code : Individual
Provider Name (Legal Business Name) : ABIGAIL MCQUILLEN COTA/L
Provider Business Mailing Address
First Line : 5056 COBRA BLVD NW
Second Line :
City : NORTH CANTON
State : OH
Zip : 44720-7202
Country : US
Telephone Number : 404-234-1313
Fax Number :
Provider Business Practice Location Address
First Line : 11136 RAVENNA RD
Second Line :
City : TWINSBURG
State : OH
Zip : 44087-1022
Country : US
Telephone Number : 330-486-2000
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 07/23/2019
Last Update Date : 07/23/2019

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Directions to “ ABIGAIL MCQUILLEN COTA/L” Practice Location

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