Provider Demographics
NPI:1063295020
Name:DOWNS, QUIANA LEE MORGAN (COTA)
Entity type:Individual
Prefix:
First Name:QUIANA
Middle Name:LEE MORGAN
Last Name:DOWNS
Suffix:
Gender:F
Credentials:COTA
Other - Prefix:
Other - First Name:QUIANA
Other - Middle Name:LEE MORGAN
Other - Last Name:BROWNE
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:1595 S CALUMET RD STE 3
Mailing Address - Street 2:
Mailing Address - City:CHESTERTON
Mailing Address - State:IN
Mailing Address - Zip Code:46304-2389
Mailing Address - Country:US
Mailing Address - Phone:219-764-4888
Mailing Address - Fax:219-898-4258
Practice Address - Street 1:1595 S CALUMET RD STE 3
Practice Address - Street 2:
Practice Address - City:CHESTERTON
Practice Address - State:IN
Practice Address - Zip Code:46304-2389
Practice Address - Country:US
Practice Address - Phone:219-764-4888
Practice Address - Fax:219-898-4258
Is Sole Proprietor?:No
Enumeration Date:2023-08-15
Last Update Date:2023-08-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN32003702A224Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes224Z00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapy Assistant
Provider Identifiers
StateIdentifier IDID TypeIssuer
IN200196020AMedicaid