Provider Demographics
NPI:1609407998
Name:CORONATO, ANN MARIE (COTA)
Entity Type:Individual
Prefix:
First Name:ANN MARIE
Middle Name:
Last Name:CORONATO
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 1:6033 S 200 W
Mailing Address - Street 2:
Mailing Address - City:COLUMBIA CITY
Mailing Address - State:IN
Mailing Address - Zip Code:46725-9768
Mailing Address - Country:US
Mailing Address - Phone:260-610-1918
Mailing Address - Fax:
Practice Address - Street 1:6033 S 200 W
Practice Address - Street 2:
Practice Address - City:COLUMBIA CITY
Practice Address - State:IN
Practice Address - Zip Code:46725-9768
Practice Address - Country:US
Practice Address - Phone:260-610-1918
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-01-27
Last Update Date:2020-01-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes224Z00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapy AssistantGroup - Single Specialty