Provider Demographics
NPI:1497033542
Name:ABATE, MIRANDA ENGELHARDT (COTA)
Entity Type:Individual
Prefix:
First Name:MIRANDA
Middle Name:ENGELHARDT
Last Name:ABATE
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 1:610 PAWNEE LN
Mailing Address - Street 2:
Mailing Address - City:BELTON
Mailing Address - State:MO
Mailing Address - Zip Code:64012-2939
Mailing Address - Country:US
Mailing Address - Phone:816-348-8858
Mailing Address - Fax:
Practice Address - Street 1:610 PAWNEE LN
Practice Address - Street 2:
Practice Address - City:BELTON
Practice Address - State:MO
Practice Address - Zip Code:64012-2939
Practice Address - Country:US
Practice Address - Phone:816-348-8858
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2011-07-22
Last Update Date:2011-07-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes224Z00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapy Assistant