Healthcare Provider Details

I. General information

NPI: 1215680491
Provider Name (Legal Business Name): EMMA HEGLAR COTA/L
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 01/28/2022
Last Update Date: 01/28/2022
Certification Date: 01/28/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

230 JAMES ACRES LN
ROCKWELL NC
28138-8491
US

IV. Provider business mailing address

230 JAMES ACRES LN
ROCKWELL NC
28138-8491
US

V. Phone/Fax

Practice location:
  • Phone: 704-213-4043
  • Fax:
Mailing address:
  • Phone: 704-213-4043
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code224Z00000X
TaxonomyOccupational Therapy Assistant
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: