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NPI Code Detail

MEDICARE: HANNAH OLIVIA CASTLE COTA

MEDICARE: HANNAH OLIVIA CASTLE 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 AssistantOT-A1429AR

General Provider Information

NPI Number : 1730650920
Entity Type Code : Individual
Provider Name (Legal Business Name) : HANNAH OLIVIA CASTLE COTA
Provider Business Mailing Address
First Line : 1421 DAVIS ST APT B
Second Line :
City : CONWAY
State : AR
Zip : 72034-3920
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 2701 T P WHITE DR
Second Line :
City : JACKSONVILLE
State : AR
Zip : 72076-2514
Country : US
Telephone Number : 501-241-0410
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 12/16/2018
Last Update Date : 12/16/2018

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Directions to “ HANNAH OLIVIA CASTLE COTA” Practice Location

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