Healthcare Provider Details

I. General information

NPI: 1639004138
Provider Name (Legal Business Name): NATALIE MARIE THOMPSON 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

1000 HIGHWAY 12
HETTINGER ND
58639-7530
US

IV. Provider business mailing address

708 7TH AVE W APT 3
LEMMON SD
57638-1761
US

V. Phone/Fax

Practice location:
  • Phone: 701-567-4561
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225X00000X
TaxonomyOccupational Therapist
License Number2215
License Number StateND

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: