Healthcare Provider Details

I. General information

NPI: 1225437924
Provider Name (Legal Business Name): EMILY HULSMANN COTA
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 08/19/2014
Last Update Date: 08/19/2014
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

324 SOUTH ELM STREET
HARRISON OH
45030
US

IV. Provider business mailing address

324 S ELM ST 324 SOUTH ELM STREET
HARRISON OH
45030-1404
US

V. Phone/Fax

Practice location:
  • Phone: 513-317-3068
  • Fax:
Mailing address:
  • Phone: 513-317-3068
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code224Z00000X
TaxonomyOccupational Therapy Assistant
License Number320002708A
License Number StateIN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: