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NPI Code Detail

MEDICARE: SHEILA SUE KIMBLE COTA

MEDICARE:   SHEILA SUE KIMBLE  COTA
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
1224Z00000XOccupational Therapy Assistant5202004917MI

General Provider Information

NPI Number : 1144557075
Entity Type Code : Individual
Provider Name (Legal Business Name) : SHEILA SUE KIMBLE COTA
Provider Business Mailing Address
First Line : 1451 EDWIN ST.
Second Line :
City : WESTLAND
State : MI
Zip : 48186-3895
Country : US
Telephone Number : 734-326-9322
Fax Number :
Provider Business Practice Location Address
First Line : 1451 EDWIN ST
Second Line :
City : WESTLAND
State : MI
Zip : 48186-3895
Country : US
Telephone Number : 734-326-9322
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 11/13/2009
Last Update Date : 11/13/2009

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Directions to “ SHEILA SUE KIMBLE COTA” Practice Location

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