Provider Demographics
NPI:1699810945
Name:CAMERON, KARA S (COTA)
Entity type:Individual
Prefix:
First Name:KARA
Middle Name:S
Last Name:CAMERON
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 1:680 S 4TH ST
Mailing Address - Street 2:
Mailing Address - City:LOUISVILLE
Mailing Address - State:KY
Mailing Address - Zip Code:40202-2407
Mailing Address - Country:US
Mailing Address - Phone:800-545-0749
Mailing Address - Fax:
Practice Address - Street 1:2100 BENT CREEK BLVD
Practice Address - Street 2:
Practice Address - City:MECHANICSBURG
Practice Address - State:PA
Practice Address - Zip Code:17050-1836
Practice Address - Country:US
Practice Address - Phone:717-918-0330
Practice Address - Fax:717-790-9510
Is Sole Proprietor?:No
Enumeration Date:2007-02-21
Last Update Date:2013-08-14
Deactivation Date:
Deactivation Code:
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Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes224Z00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapy Assistant
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA396648Medicare Oscar/Certification