Provider Demographics
NPI:1174005797
Name:KEENAN, ANITA (COTA)
Entity Type:Individual
Prefix:MS
First Name:ANITA
Middle Name:
Last Name:KEENAN
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 1:256 JOHN SCOTT HWY
Mailing Address - Street 2:
Mailing Address - City:STEUBENVILLE
Mailing Address - State:OH
Mailing Address - Zip Code:43952-3001
Mailing Address - Country:US
Mailing Address - Phone:740-264-7176
Mailing Address - Fax:740-264-0399
Practice Address - Street 1:256 JOHN SCOTT HWY
Practice Address - Street 2:
Practice Address - City:STEUBENVILLE
Practice Address - State:OH
Practice Address - Zip Code:43952-3001
Practice Address - Country:US
Practice Address - Phone:740-264-7176
Practice Address - Fax:740-264-0399
Is Sole Proprietor?:Yes
Enumeration Date:2018-08-30
Last Update Date:2018-08-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHOTA001346224Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes224Z00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapy Assistant