MEDICARE: BECKY VANN KERR 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
1	224Z00000X	Occupational Therapy Assistant	7301	NC

General Provider Information

NPI Number	:	1679806186
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	BECKY VANN KERR COTA

Provider Business Mailing Address
First Line	:	3411 PAGE RD
Second Line	:
City	:	MORRISVILLE
State	:	NC
Zip	:	27560-8544
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	3411 PAGE RD
Second Line	:
City	:	MORRISVILLE
State	:	NC
Zip	:	27560-8544
Country	:	US
Telephone Number	:	919-730-4089
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	09/15/2009
Last Update Date	:	09/15/2009

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