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General NPI Number Information
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NPI Number | 1053870196
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Entity Type | Individual
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Provider Name | KELLIE SCHMIDT COTA
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Gender | Female
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Dates
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Enumeration Date | 03/18/2019
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Last Update Date | 03/23/2022
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Provider Practice Location Address
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Address Line | 5575 PLEASANTVIEW CT
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City | BRADENTON
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State | FL
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Zip | 34211-2758
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Country | US
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Telephone | 816-885-0497
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Fax | 855-232-8604
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Provider Business Mailing Address
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Address Line | 5575 PLEASANTVIEW CT
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City | BRADENTON
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State | FL
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Zip | 34211-2758
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Country | US
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Telephone | 816-885-0497
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Fax | 855-232-8604
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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 | 1801434
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License Number State | KS
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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 | 2015031004
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License Number State | MO
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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 | OTA17530
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License Number State | FL
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