Provider Demographics
NPI:1619445095
Name:VERCHER, JODY (COTA)
Entity Type:Individual
Prefix:MRS
First Name:JODY
Middle Name:
Last Name:VERCHER
Suffix:
Gender:F
Credentials:COTA
Other - Prefix:
Other - First Name:JODY
Other - Middle Name:
Other - Last Name:SMITH
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:COTA
Mailing Address - Street 1:149 CONTRAIL DR
Mailing Address - Street 2:
Mailing Address - City:KEARNEYSVILLE
Mailing Address - State:WV
Mailing Address - Zip Code:25430-2899
Mailing Address - Country:US
Mailing Address - Phone:713-305-3453
Mailing Address - Fax:855-232-8604
Practice Address - Street 1:149 CONTRAIL DR
Practice Address - Street 2:
Practice Address - City:KEARNEYSVILLE
Practice Address - State:WV
Practice Address - Zip Code:25430-2899
Practice Address - Country:US
Practice Address - Phone:713-305-3453
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-11-05
Last Update Date:2018-11-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX213286224Z00000X
WVC2165224Z00000X
VA0131001854224Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes224Z00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapy Assistant