Healthcare Provider Details

I. General information

NPI: 1265337471
Provider Name (Legal Business Name): ERIN LYNEMA COTA
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 10/09/2026
Last Update Date: 10/09/2026
Certification Date: 10/09/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1401 E VAN DEINSE ST
GREENVILLE MI
48838-9186
US

IV. Provider business mailing address

1624 WINTER CREEK CT
GREENVILLE MI
48838-1667
US

V. Phone/Fax

Practice location:
  • Phone: 616-862-2502
  • Fax:
Mailing address:
  • Phone: 616-862-2502
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225X00000X
TaxonomyOccupational Therapist
License Number5202008272
License Number StateMI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: