Cheng Cha, COTA

Individual provider Active NPI Occupational Therapy Assistant · Winder, GA

NPI 1831413178 · NPPES record last updated Aug 28, 2019

Key facts

NPI
1831413178
Entity type
Individual (NPI type 1)
Primary specialty
Occupational Therapy Assistant 224Z00000X
License
OTA002281 (GA)
Practice address
422 Renown CT
Winder, GA 30680-4022
Phone
(678) 898-9404
NPI assigned
Mar 15, 2010
Sex
Female
Sole proprietor
Yes

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
No

State licenses

LicenseStateTypeSpecialty
OTA002281GAMDOccupational Therapy Assistant

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Occupational Therapy Assistant 224Z00000X OTA002281 GA Yes

Addresses

Primary practice location

422 Renown CT
Winder, GA 30680-4022

Mailing address

5266 Capac Rd
Mussey, MI 48014-1901

Other identifiers

IdentifierTypeStateIssuer
1OtherMEDICARE

Electronic endpoints

TypeEndpointUseAffiliation
CONNECT URL Winder

Other providers in Winder, GA

All providers in Winder, GA · Occupational Therapy Assistant in Georgia

Sources for this page

Verify at the official NPI Registry.