MEDICARE: MRS. YVETTE AMANDA TROTMAN C.O.T.A.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	224Z00000X	Occupational Therapy Assistant	A01717	MD

General Provider Information

NPI Number	:	1043511413
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MRS. YVETTE AMANDA TROTMAN C.O.T.A.

Provider Business Mailing Address
First Line	:	3855 GREENSPRING AVE
Second Line	:
City	:	BALTIMORE
State	:	MD
Zip	:	21211-3300
Country	:	US
Telephone Number	:	410-225-9160
Fax Number	:	410-225-9351

Provider Business Practice Location Address
First Line	:	3855 GREENSPRING AVE
Second Line	:
City	:	BALTIMORE
State	:	MD
Zip	:	21211-3300
Country	:	US
Telephone Number	:	410-225-9160
Fax Number	:	410-225-9351

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	11/16/2010
Last Update Date	:	11/16/2010

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