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NPI Code Detail

MEDICARE: MRS. CARRIE YOUSSEF COTA

MEDICARE: MRS. CARRIE YOUSSEF 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 Assistant5202007590MI

General Provider Information

NPI Number : 1659785160
Entity Type Code : Individual
Provider Name (Legal Business Name) : MRS. CARRIE YOUSSEF COTA
Provider Business Mailing Address
First Line : 1656 BELMONT DR
Second Line :
City : MOUNT PLEASANT
State : MI
Zip : 48858-1008
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 1222 NORTH DR
Second Line :
City : MOUNT PLEASANT
State : MI
Zip : 48858-3200
Country : US
Telephone Number : 260-442-1361
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 06/12/2014
Last Update Date : 06/12/2014

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