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General NPI Number Information
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NPI Number | 1033411400
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Entity Type | Individual
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Provider Name | GRACE KATHRYN HAZELL COTA
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Gender | Female
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Dates
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Enumeration Date | 11/17/2010
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Last Update Date | 07/20/2025
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Provider Practice Location Address
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Address Line | 920 S CHELTON RD
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City | COLORADO SPRINGS
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State | CO
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Zip | 80910-2311
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Country | US
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Telephone | 719-473-1283
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Fax |
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Provider Business Mailing Address
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Address Line | 6808 64TH PL NE UNIT A
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City | MARYSVILLE
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State | WA
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Zip | 98270-5313
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Country | US
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Telephone | 719-433-0192
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 224Z00000X
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Taxonomy Name | Occupational Therapy Assistant
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License Number | OC 60414053
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License Number State | WA
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Taxonomy #2
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Taxonomy Code | 224Z00000X
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Taxonomy Name | Occupational Therapy Assistant
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License Number | OTA 0000532
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License Number State | CO
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Taxonomy #3
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Taxonomy Code | 224Z00000X
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Taxonomy Name | Occupational Therapy Assistant
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License Number | 32000654A
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License Number State | IN
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Taxonomy #4
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Taxonomy Code | 224Z00000X
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Taxonomy Name | Occupational Therapy Assistant
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License Number | 6975
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License Number State | CA
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