Provider Demographics
NPI:1386926731
Name:COOTS, KAREN LYNNE (COTA/L)
Entity type:Individual
Prefix:
First Name:KAREN
Middle Name:LYNNE
Last Name:COOTS
Suffix:
Gender:F
Credentials:COTA/L
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 296
Mailing Address - Street 2:12835 SECOND AVE
Mailing Address - City:TRINWAY
Mailing Address - State:OH
Mailing Address - Zip Code:43842
Mailing Address - Country:US
Mailing Address - Phone:740-586-8634
Mailing Address - Fax:
Practice Address - Street 1:12835 2ND AVE
Practice Address - Street 2:
Practice Address - City:TRINWAY
Practice Address - State:OH
Practice Address - Zip Code:43842-7709
Practice Address - Country:US
Practice Address - Phone:740-586-8634
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-09-12
Last Update Date:2011-09-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH03830224Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes224Z00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapy Assistant