Provider Demographics
NPI:1144659822
Name:MCCOWAN, CATHERINE (COTA)
Entity type:Individual
Prefix:
First Name:CATHERINE
Middle Name:
Last Name:MCCOWAN
Suffix:
Gender:F
Credentials:COTA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:15051 HARMONY HILLS LANE
Mailing Address - Street 2:
Mailing Address - City:ABINGDON
Mailing Address - State:VA
Mailing Address - Zip Code:24212
Mailing Address - Country:US
Mailing Address - Phone:276-415-2590
Mailing Address - Fax:276-619-2488
Practice Address - Street 1:15051 HARMONY HILLS LANE
Practice Address - Street 2:
Practice Address - City:ABINGDON
Practice Address - State:VA
Practice Address - Zip Code:24212
Practice Address - Country:US
Practice Address - Phone:276-415-2590
Practice Address - Fax:276-619-2488
Is Sole Proprietor?:Yes
Enumeration Date:2013-11-04
Last Update Date:2013-11-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0131001180224Z00000X
KYA3988224Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes224Z00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapy Assistant