Provider Demographics
NPI:1427563642
Name:MYERS, MAKAYLA (COTA)
Entity Type:Individual
Prefix:
First Name:MAKAYLA
Middle Name:
Last Name:MYERS
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 1:8 COURT ST
Mailing Address - Street 2:
Mailing Address - City:WOONSOCKET
Mailing Address - State:RI
Mailing Address - Zip Code:02895-4402
Mailing Address - Country:US
Mailing Address - Phone:401-235-6049
Mailing Address - Fax:
Practice Address - Street 1:8 COURT ST
Practice Address - Street 2:
Practice Address - City:WOONSOCKET
Practice Address - State:RI
Practice Address - Zip Code:02895-4402
Practice Address - Country:US
Practice Address - Phone:401-235-6049
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2017-12-11
Last Update Date:2017-12-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
RIOTA00976224Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes224Z00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapy Assistant
Provider Identifiers
StateIdentifier IDID TypeIssuer
RIOTA00976OtherOCCUPATIONAL THERAPY ASSISTANT