Healthcare Provider Details

I. General information

NPI: 1659798544
Provider Name (Legal Business Name): RACHEL ROBINSON MEREDITH COTA/L
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 03/28/2014
Last Update Date: 03/28/2014
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1646 MILITARY HWY RED RIVER REHAB
PINEVILLE LA
71360
US

IV. Provider business mailing address

333 WILLIFORD RD
BALL LA
71405
US

V. Phone/Fax

Practice location:
  • Phone: 318-443-9305
  • Fax:
Mailing address:
  • Phone: 318-613-7538
  • Fax: 318-443-3143

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code224Z00000X
TaxonomyOccupational Therapy Assistant
License NumberZ20518
License Number StateLA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: