Provider Demographics
NPI:1851061642
Name:BEHLING, TODD ALLEN (COTA)
Entity Type:Individual
Prefix:
First Name:TODD
Middle Name:ALLEN
Last Name:BEHLING
Suffix:
Gender:M
Credentials:COTA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:29726 COUNTY ROAD 22
Mailing Address - Street 2:
Mailing Address - City:ELKHART
Mailing Address - State:IN
Mailing Address - Zip Code:46517-8612
Mailing Address - Country:US
Mailing Address - Phone:574-261-9500
Mailing Address - Fax:
Practice Address - Street 1:5024 W WESTERN AVE
Practice Address - Street 2:
Practice Address - City:SOUTH BEND
Practice Address - State:IN
Practice Address - Zip Code:46619-2312
Practice Address - Country:US
Practice Address - Phone:574-318-4600
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-09-14
Last Update Date:2021-09-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN32002774A224Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes224Z00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapy Assistant