Provider Demographics
NPI:1477755130
Name:HINES, KAREN S (COTA)
Entity Type:Individual
Prefix:MS
First Name:KAREN
Middle Name:S
Last Name:HINES
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 1:748 KEPLINGER AVE
Mailing Address - Street 2:
Mailing Address - City:ALLIANCE
Mailing Address - State:OH
Mailing Address - Zip Code:44601-2956
Mailing Address - Country:US
Mailing Address - Phone:330-614-9402
Mailing Address - Fax:
Practice Address - Street 1:1035 E LINCOLNWAY
Practice Address - Street 2:
Practice Address - City:MINERVA
Practice Address - State:OH
Practice Address - Zip Code:44657-1215
Practice Address - Country:US
Practice Address - Phone:330-868-4147
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-06-04
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHOTA-00897224Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes224Z00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapy Assistant