Provider Demographics
NPI:1659189819
Name:AGYEI-YEBOAH, RITA (COTA)
Entity type:Individual
Prefix:
First Name:RITA
Middle Name:
Last Name:AGYEI-YEBOAH
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 1:145 BOBBYS BRANCH RD
Mailing Address - Street 2:
Mailing Address - City:MILLSBORO
Mailing Address - State:DE
Mailing Address - Zip Code:19966-3755
Mailing Address - Country:US
Mailing Address - Phone:302-339-0805
Mailing Address - Fax:
Practice Address - Street 1:900 BOOTH ST
Practice Address - Street 2:
Practice Address - City:SALISBURY
Practice Address - State:MD
Practice Address - Zip Code:21801-3006
Practice Address - Country:US
Practice Address - Phone:410-742-8896
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-12-20
Last Update Date:2024-12-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DEU2-0012308224Z00000X
MDA03258224Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes224Z00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapy Assistant