Provider Demographics
NPI:1366650087
Name:PHILYAW, RITA ANN (COTA)
Entity Type:Individual
Prefix:MRS
First Name:RITA
Middle Name:ANN
Last Name:PHILYAW
Suffix:
Gender:F
Credentials:COTA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:1212 TAYLOR PL SE
Mailing Address - Street 2:
Mailing Address - City:LENOIR
Mailing Address - State:NC
Mailing Address - Zip Code:28645-6251
Mailing Address - Country:US
Mailing Address - Phone:828-728-4521
Mailing Address - Fax:828-728-4521
Practice Address - Street 1:1212 TAYLOR PL SE
Practice Address - Street 2:
Practice Address - City:LENOIR
Practice Address - State:NC
Practice Address - Zip Code:28645-6251
Practice Address - Country:US
Practice Address - Phone:828-728-4521
Practice Address - Fax:828-728-4521
Is Sole Proprietor?:No
Enumeration Date:2007-05-18
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC2290224Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes224Z00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapy Assistant