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NPI Code Detail

MEDICARE: MS. AMANDA LEIGH GUTHRIE COTA

MEDICARE: MS. AMANDA LEIGH GUTHRIE 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 AssistantC1625WV

General Provider Information

NPI Number : 1376662734
Entity Type Code : Individual
Provider Name (Legal Business Name) : MS. AMANDA LEIGH GUTHRIE COTA
Provider Business Mailing Address
First Line : 5102 HEATHER PL
Second Line :
City : CHARLESTON
State : WV
Zip : 25313-2206
Country : US
Telephone Number : 304-776-2304
Fax Number :
Provider Business Practice Location Address
First Line : 4000 OUT LOOK DR
Second Line :
City : HURRICANE
State : WV
Zip : 25526-9467
Country : US
Telephone Number : 304-757-4102
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 03/28/2007
Last Update Date : 07/08/2007

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