Healthcare Provider Details

I. General information

NPI: 1962927749
Provider Name (Legal Business Name): ANDREA PAIGE COTTER LLMSW
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/14/2017
Last Update Date: 08/14/2017
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

301 S CRAPO ST
MT PLEASANT MI
48858-2941
US

IV. Provider business mailing address

317 E 7TH ST
CLARE MI
48617-1305
US

V. Phone/Fax

Practice location:
  • Phone: 989-775-7701
  • Fax:
Mailing address:
  • Phone: 989-560-7505
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code171M00000X
TaxonomyCase Manager/Care Coordinator
License Number6801100992
License Number StateMI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: