Provider Demographics
NPI:1013034123
Name:MITCHELL, BARBARA MARIE (COTA L)
Entity Type:Individual
Prefix:MRS
First Name:BARBARA
Middle Name:MARIE
Last Name:MITCHELL
Suffix:
Gender:F
Credentials:COTA L
Other - Prefix:MISS
Other - First Name:BARBARA
Other - Middle Name:MARIE
Other - Last Name:MITCHELL
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:COTA L
Mailing Address - Street 1:185 SCHOOL HOUSE RD
Mailing Address - Street 2:
Mailing Address - City:BOYERTOWN
Mailing Address - State:PA
Mailing Address - Zip Code:19512-7915
Mailing Address - Country:US
Mailing Address - Phone:610-568-0819
Mailing Address - Fax:
Practice Address - Street 1:185 SCHOOL HOUSE RD
Practice Address - Street 2:
Practice Address - City:BOYERTOWN
Practice Address - State:PA
Practice Address - Zip Code:19512-7915
Practice Address - Country:US
Practice Address - Phone:610-568-0819
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-23
Last Update Date:2013-11-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAOP001588L224Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes224Z00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapy Assistant