Provider Demographics
NPI:1467730085
Name:TATSCH, LINDA (COTA)
Entity Type:Individual
Prefix:
First Name:LINDA
Middle Name:
Last Name:TATSCH
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:PO BOX 286
Mailing Address - Street 2:525 WESTMORELAND
Mailing Address - City:MASON
Mailing Address - State:TX
Mailing Address - Zip Code:76856-0286
Mailing Address - Country:US
Mailing Address - Phone:325-347-7352
Mailing Address - Fax:
Practice Address - Street 1:448 SIDNEY BAKER ST S STE 103
Practice Address - Street 2:
Practice Address - City:KERRVILLE
Practice Address - State:TX
Practice Address - Zip Code:78028-5980
Practice Address - Country:US
Practice Address - Phone:830-896-3130
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-07-31
Last Update Date:2011-07-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX210273224Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes224Z00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapy Assistant
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX210273OtherEXECUTIVE COUNCIL OF PHYSICAL THERAPY AND OCCUPATIONAL THERAPY EXAMINERS