Healthcare Provider Details

I. General information

NPI: 1689507907
Provider Name (Legal Business Name): ULYANA KOTAVA
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/05/2026
Last Update Date: 06/05/2026
Certification Date: 06/05/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

571 HOLLIS ST
DUNSTABLE MA
01827-1503
US

IV. Provider business mailing address

571 HOLLIS ST
DUNSTABLE MA
01827-1503
US

V. Phone/Fax

Practice location:
  • Phone: 603-557-3773
  • Fax:
Mailing address:
  • Phone: 603-557-3773
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code175F00000X
TaxonomyNaturopath
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: