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General NPI Number Information
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NPI Number | 1073450391
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Entity Type | Individual
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Provider Name | CHLOE ROY COTA
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Gender | Female
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Dates
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Enumeration Date | 05/04/2026
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Last Update Date | 05/04/2026
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Provider Practice Location Address
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Address Line | 695 2ND ST STE D
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City | JASPER
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State | IN
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Zip | 47546-3249
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Country | US
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Telephone | 812-996-0682
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Fax |
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Provider Business Mailing Address
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Address Line | 897 S COUNTY ROAD 175 E
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City | WINSLOW
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State | IN
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Zip | 47598-8653
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Country | US
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Telephone | 812-491-3856
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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 | 32003734A
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License Number State | IN
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