Healthcare Provider Details

I. General information

NPI: 1255259453
Provider Name (Legal Business Name): ANITA HART GUFFEY COTA/L
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: ANITA J HA COTA/L

II. Dates (important events)

Enumeration Date: 07/07/2026
Last Update Date: 07/07/2026
Certification Date: 07/07/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

107 LOVETT DR
GREENVILLE SC
29607-6510
US

IV. Provider business mailing address

109 GIBBY LN
SIMPSONVILLE SC
29681-3874
US

V. Phone/Fax

Practice location:
  • Phone: 803-490-0960
  • Fax:
Mailing address:
  • Phone: 864-357-3852
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225XP0200X
TaxonomyPediatric Occupational Therapist
License Number3208
License Number StateSC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: