Healthcare Provider Details

I. General information

NPI: 1902550437
Provider Name (Legal Business Name): MARGOT VANONI COTA
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 02/03/2022
Last Update Date: 09/27/2023
Certification Date: 09/27/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2470 DUG GAP RD
DALTON GA
30720-9210
US

IV. Provider business mailing address

4109 EAST RIDGE DRIVE
CHATTANOOGA TN
37412-2307
US

V. Phone/Fax

Practice location:
  • Phone: 512-567-1127
  • Fax: 855-232-8604
Mailing address:
  • Phone: 512-567-1127
  • Fax: 855-232-8604

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code224Z00000X
TaxonomyOccupational Therapy Assistant
License Number217111
License Number StateTX
# 2
Primary TaxonomyY
Taxonomy Code224Z00000X
TaxonomyOccupational Therapy Assistant
License NumberOTA003018
License Number StateGA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: