Healthcare Provider Details

I. General information

NPI: 1932336682
Provider Name (Legal Business Name): ROBBIN MARIE GOODE COTA
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 06/19/2009
Last Update Date: 06/19/2009
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

651 S STATE ST
FRANKLIN IN
46131-2552
US

IV. Provider business mailing address

76 PEAVINE RD
MARTINSVILLE IN
46151-9070
US

V. Phone/Fax

Practice location:
  • Phone: 317-736-6414
  • Fax:
Mailing address:
  • Phone: 317-446-8949
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code224Z00000X
TaxonomyOccupational Therapy Assistant
License Number32000766A
License Number StateIN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: