Healthcare Provider Details

I. General information

NPI: 1750216214
Provider Name (Legal Business Name): MEGAN BARTON COTA
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/16/2026
Last Update Date: 06/16/2026
Certification Date: 06/16/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1481 BYHALIA RD
HERNANDO MS
38632-1003
US

IV. Provider business mailing address

1481 BYHALIA RD
HERNANDO MS
38632-1003
US

V. Phone/Fax

Practice location:
  • Phone: 662-469-2906
  • Fax: 662-469-4229
Mailing address:
  • Phone: 662-469-2906
  • Fax: 662-469-4229

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code224Z00000X
TaxonomyOccupational Therapy Assistant
License Number2786
License Number StateMS

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: