Provider Demographics
NPI:1447692959
Name:ABELLA, RAYSHA RENEE (COTA/L)
Entity type:Individual
Prefix:
First Name:RAYSHA
Middle Name:RENEE
Last Name:ABELLA
Suffix:
Gender:F
Credentials:COTA/L
Other - Prefix:
Other - First Name:RAYSHA
Other - Middle Name:RENEE
Other - Last Name:SMITH
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:COTA/L
Mailing Address - Street 1:3221 KATHERINE ST
Mailing Address - Street 2:
Mailing Address - City:FORT MYERS
Mailing Address - State:FL
Mailing Address - Zip Code:33916-6516
Mailing Address - Country:US
Mailing Address - Phone:786-458-1953
Mailing Address - Fax:
Practice Address - Street 1:4920 VICEROY CT
Practice Address - Street 2:
Practice Address - City:CAPE CORAL
Practice Address - State:FL
Practice Address - Zip Code:33904-9048
Practice Address - Country:US
Practice Address - Phone:239-542-3121
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-07-25
Last Update Date:2023-03-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLOTA12323224Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes224Z00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapy Assistant