Provider Demographics
NPI:1992041206
Name:GALA, KULWANT KAUR (COTA/L)
Entity type:Individual
Prefix:
First Name:KULWANT
Middle Name:KAUR
Last Name:GALA
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 1:6418 SW 12TH CT
Mailing Address - Street 2:
Mailing Address - City:OCALA
Mailing Address - State:FL
Mailing Address - Zip Code:34471-9702
Mailing Address - Country:US
Mailing Address - Phone:352-629-0760
Mailing Address - Fax:352-629-0760
Practice Address - Street 1:6418 SW 12TH CT
Practice Address - Street 2:
Practice Address - City:OCALA
Practice Address - State:FL
Practice Address - Zip Code:34471-9702
Practice Address - Country:US
Practice Address - Phone:352-629-0760
Practice Address - Fax:352-629-0760
Is Sole Proprietor?:No
Enumeration Date:2012-12-14
Last Update Date:2012-12-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLOTA 8831224Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes224Z00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapy Assistant