Healthcare Provider Details

I. General information

NPI: 1083551360
Provider Name (Legal Business Name): MORGAN PROSSER COTA/L
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/04/2026
Last Update Date: 05/04/2026
Certification Date: 05/04/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

106 E MARTINTOWN RD
NORTH AUGUSTA SC
29841-3425
US

IV. Provider business mailing address

807 SAINT ANDREWS DR
AUGUSTA GA
30909-7808
US

V. Phone/Fax

Practice location:
  • Phone: 803-993-9959
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code224Z00000X
TaxonomyOccupational Therapy Assistant
License NumberOTA.5894
License Number StateSC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: