Provider Demographics
NPI:1588952121
Name:GARRETT, TERESA (COTA)
Entity type:Individual
Prefix:
First Name:TERESA
Middle Name:
Last Name:GARRETT
Suffix:
Gender:F
Credentials:COTA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3385 COOPER RD
Mailing Address - Street 2:
Mailing Address - City:CUMBERLAND
Mailing Address - State:OH
Mailing Address - Zip Code:43732-9708
Mailing Address - Country:US
Mailing Address - Phone:740-638-2898
Mailing Address - Fax:
Practice Address - Street 1:3385 COOPER RD
Practice Address - Street 2:
Practice Address - City:CUMBERLAND
Practice Address - State:OH
Practice Address - Zip Code:43732-9708
Practice Address - Country:US
Practice Address - Phone:740-638-2898
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-07-18
Last Update Date:2011-07-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH04505224Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes224Z00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapy Assistant