Kelly Lee Taylor, COTA
Occupational Therapy Assistant in South Bend, IN. Individual provider (NPI-1).
NPI number1821369984
StatusActive
Last updated in NPPESJan 21, 2012
Details
- NPI
- 1821369984
- Entity type
- Individual (NPI-1)
- Name
- Miss Kelly Lee Taylor
- Credential
- COTA
- Sex
- Female
- Sole proprietor
- No
- Enumeration date
- Jan 21, 2012
- Last updated
- Jan 21, 2012
Medicare and OIG
- Medicare enrolled (PECOS)
- Not in the Medicare enrollment file
- Can order and refer
- Not on the CMS order and referring list
- OIG exclusion list
- This NPI is not listed
CMS and OIG files of November 2026. PECOS lookup · OIG exclusion check
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 224Z00000X | Occupational Therapy Assistant | 32002094A | IN | Yes |
Practice location
2012 Ironwood CirSuite 230
South Bend, IN 46635-1888
Phone 574-387-4049
Mailing address
1805 Milburn BlvdMishawaka, IN 46544-4629
Phone 574-850-8953
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This page shows exactly what the provider filed with NPPES. Only the provider (or their surrogate) can change it, by signing in to NPPES. Our page updates within a day of their change. See how to update NPI information.
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All 35 Occupational Therapy Assistant providers in South Bend · All 3,973 providers in South Bend
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