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NPI Code Detail

MEDICARE: REBECCA ANN MOORE COTA/L

MEDICARE: REBECCA ANN MOORE 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 Assistant04947OH

General Provider Information

NPI Number : 1962746412
Entity Type Code : Individual
Provider Name (Legal Business Name) : REBECCA ANN MOORE COTA/L
Provider Business Mailing Address
First Line : 3347 STEVIE LN
Second Line :
City : CINCINNATI
State : OH
Zip : 45239-6221
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 476 RIDDLE RD
Second Line :
City : CINCINNATI
State : OH
Zip : 45220-2411
Country : US
Telephone Number : 513-281-8001
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 11/22/2012
Last Update Date : 11/22/2012

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Directions to “ REBECCA ANN MOORE COTA/L” Practice Location

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