Provider Demographics
NPI:1467728782
Name:EATON, JAMES PAUL (COTA/L)
Entity Type:Individual
Prefix:MR
First Name:JAMES
Middle Name:PAUL
Last Name:EATON
Suffix:
Gender:M
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 1:16 SHANGRI LA BLVD
Mailing Address - Street 2:
Mailing Address - City:EAST WAREHAM
Mailing Address - State:MA
Mailing Address - Zip Code:02538-1116
Mailing Address - Country:US
Mailing Address - Phone:508-291-2259
Mailing Address - Fax:
Practice Address - Street 1:146 MACARTHUR BLVD
Practice Address - Street 2:
Practice Address - City:BOURNE
Practice Address - State:MA
Practice Address - Zip Code:02532-3902
Practice Address - Country:US
Practice Address - Phone:508-759-8880
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-03-30
Last Update Date:2012-03-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA3448224Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes224Z00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapy Assistant