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NPI Code Detail

MEDICARE: JENNIFER LYNN LASLEY COTA

MEDICARE: JENNIFER LYNN LASLEY 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 Assistant18-00456KS

General Provider Information

NPI Number : 1811266687
Entity Type Code : Individual
Provider Name (Legal Business Name) : JENNIFER LYNN LASLEY COTA
Provider Business Mailing Address
First Line : 15516 POPLAR ST
Second Line :
City : BASEHOR
State : KS
Zip : 66007-9742
Country : US
Telephone Number : 913-724-3161
Fax Number :
Provider Business Practice Location Address
First Line : 2915 STRONG AVE
Second Line : SPECTRUM HOME HEALTH
City : KANSAS CITY
State : KS
Zip : 66106-9742
Country : US
Telephone Number : 913-831-2979
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 12/22/2011
Last Update Date : 12/22/2011

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Directions to “ JENNIFER LYNN LASLEY COTA” Practice Location

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