Provider Demographics
NPI:1710661491
Name:GERMAIN, TAYLOR ELIZABETH (COTA/L)
Entity Type:Individual
Prefix:
First Name:TAYLOR
Middle Name:ELIZABETH
Last Name:GERMAIN
Suffix:
Gender:F
Credentials:COTA/L
Other - Prefix:MRS
Other - First Name:TAYLOR
Other - Middle Name:ELIZABETH
Other - Last Name:COIA
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:291 SAMUEL GORTON AVE
Mailing Address - Street 2:
Mailing Address - City:WARWICK
Mailing Address - State:RI
Mailing Address - Zip Code:02889-5422
Mailing Address - Country:US
Mailing Address - Phone:401-744-2198
Mailing Address - Fax:
Practice Address - Street 1:45 SOCKANOSSET CROSS RD STE 100
Practice Address - Street 2:
Practice Address - City:CRANSTON
Practice Address - State:RI
Practice Address - Zip Code:02920-5529
Practice Address - Country:US
Practice Address - Phone:401-409-2608
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-06-13
Last Update Date:2023-06-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
RIOTA01194224Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes224Z00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapy Assistant