Coby Cedarholm, COTA/L
Individual provider Active NPI Occupational Therapy Assistant · Overland Park, KS
NPI 1982116356 · NPPES record last updated Oct 25, 2017
Key facts
- NPI
- 1982116356
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Occupational Therapy Assistant 224Z00000X
- License
- 2015018415 (MO)
- Practice address
- 5100 Indian Creek Pkwy
Overland Park, KS 66207-4115 - Phone
- (913) 967-5222
- NPI assigned
- Oct 25, 2017
- Sex
- Male
- Sole proprietor
- No
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 2015018415 | MO | MD | Occupational Therapy Assistant |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Occupational Therapy Assistant | 224Z00000X | 2015018415 | MO | Yes |
Addresses
Primary practice location
5100 Indian Creek Pkwy
Overland Park, KS 66207-4115
Mailing address
545 Jefferson Cir
Liberty, MO 64068-1440
Phone (816) 679-4287
Other providers in Overland Park, KS
- Timothy B Cavanaugh
- Hannah Caviness
- CCRC of Cedar Rapids, LLC
- CCRC of Overland Park, LLC
- Cecily a. Clark-Ganheart, M.D., P.a.
- Ashley Celis
- Centered Counseling, LLC
- Centered Mind LLC
- Centerwell Certified Healthcare Corp.
- Centerwell Senior Primary Care KS PA
All providers in Overland Park, KS · Occupational Therapy Assistant in Kansas
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Oct 25, 2017. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.