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NPI Code Detail

MEDICARE: DEANNA R REISH COTA

MEDICARE: DEANNA R REISH 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 AssistantCOTA 034WY

General Provider Information

NPI Number : 1770601684
Entity Type Code : Individual
Provider Name (Legal Business Name) : DEANNA R REISH COTA
Provider Business Mailing Address
First Line : 6631 E 2ND ST
Second Line :
City : CASPER
State : WY
Zip : 82609-4355
Country : US
Telephone Number : 307-268-9904
Fax Number : 307-268-9907
Provider Business Practice Location Address
First Line : 6631 E 2ND ST
Second Line :
City : CASPER
State : WY
Zip : 82609-4355
Country : US
Telephone Number : 307-268-9904
Fax Number : 307-268-9907
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 03/27/2007
Last Update Date : 12/07/2010

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Directions to “ DEANNA R REISH COTA” Practice Location

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