Healthcare Provider Details

I. General information

NPI: 1265947485
Provider Name (Legal Business Name): BRITTANY ELIZABETH MCFARLAND COTA/L
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 12/11/2017
Last Update Date: 12/11/2017
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

15089 HARMONY HILLS LN
ABINGDON VA
24211-7661
US

IV. Provider business mailing address

15089 HARMONY HILLS LN
ABINGDON VA
24211-7661
US

V. Phone/Fax

Practice location:
  • Phone: 276-206-8776
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code226000000X
TaxonomyRecreational Therapist Assistant
License Number0131001507
License Number StateVA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: