Provider Demographics
NPI:1073857314
Name:TRUMBO, TOYA L (COTA/L)
Entity Type:Individual
Prefix:
First Name:TOYA
Middle Name:L
Last Name:TRUMBO
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 1584
Mailing Address - Street 2:
Mailing Address - City:DANVILLE
Mailing Address - State:KY
Mailing Address - Zip Code:40423-1584
Mailing Address - Country:US
Mailing Address - Phone:859-516-8308
Mailing Address - Fax:
Practice Address - Street 1:3802 KLONDIKE LN
Practice Address - Street 2:
Practice Address - City:LOUISVILLE
Practice Address - State:KY
Practice Address - Zip Code:40218-1715
Practice Address - Country:US
Practice Address - Phone:502-452-1579
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2012-11-26
Last Update Date:2020-06-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KYKY-A3495224Z00000X
KY134861224Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes224Z00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapy Assistant