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NPI Code Detail

MEDICARE: MICHELLE LORAINE HIXSON COTA/L

MEDICARE:   MICHELLE LORAINE HIXSON  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 Assistant10023NC

General Provider Information

NPI Number : 1497218671
Entity Type Code : Individual
Provider Name (Legal Business Name) : MICHELLE LORAINE HIXSON COTA/L
Provider Business Mailing Address
First Line : 222 SHADY SUMMIT WAY
Second Line :
City : RALEIGH
State : NC
Zip : 27603-4873
Country : US
Telephone Number : 937-371-8741
Fax Number :
Provider Business Practice Location Address
First Line : 2722 SPRING FOREST RD
Second Line :
City : RALEIGH
State : NC
Zip : 27616-1977
Country : US
Telephone Number : 919-863-7770
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 04/13/2019
Last Update Date : 04/13/2019

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Directions to “ MICHELLE LORAINE HIXSON COTA/L” Practice Location

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