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NPI Code Detail

MEDICARE: AMBER NICOLE NELSON COTA/L

MEDICARE: AMBER NICOLE NELSON COTA/L
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 AssistantC1779WV

General Provider Information

NPI Number : 1386948545
Entity Type Code : Individual
Provider Name (Legal Business Name) : AMBER NICOLE NELSON COTA/L
Provider Business Mailing Address
First Line : 505 CALDWELL LN
Second Line :
City : DUNBAR
State : WV
Zip : 25064-2026
Country : US
Telephone Number : 304-444-8466
Fax Number :
Provider Business Practice Location Address
First Line : 505 CALDWELL LN
Second Line :
City : DUNBAR
State : WV
Zip : 25064-2026
Country : US
Telephone Number : 304-444-8466
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 01/03/2011
Last Update Date : 09/03/2013

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Directions to “ AMBER NICOLE NELSON COTA/L” Practice Location

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