Provider Demographics
NPI:1730425877
Name:KANNEY, NATHAN ALLEN (COTA)
Entity type:Individual
Prefix:
First Name:NATHAN
Middle Name:ALLEN
Last Name:KANNEY
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 1:490 STEVENS CT
Mailing Address - Street 2:
Mailing Address - City:BUCYRUS
Mailing Address - State:OH
Mailing Address - Zip Code:44820-3126
Mailing Address - Country:US
Mailing Address - Phone:419-563-4484
Mailing Address - Fax:
Practice Address - Street 1:2820 GREENACRE DR
Practice Address - Street 2:
Practice Address - City:FINDLAY
Practice Address - State:OH
Practice Address - Zip Code:45840-4157
Practice Address - Country:US
Practice Address - Phone:419-424-1808
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-12-18
Last Update Date:2012-12-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHOTA . 05200224Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes224Z00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapy Assistant