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General NPI Number Information
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NPI Number | 1144092768
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Entity Type | Individual
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Provider Name | BRIONNA MAY SWANSON COTA/L
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Gender | Female
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Dates
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Enumeration Date | 10/26/2023
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Last Update Date | 10/26/2023
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Provider Practice Location Address
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Address Line | 4706 ASHVILLE RD
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City | ASHVILLE
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State | NY
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Zip | 14710-9728
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Country | US
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Telephone | 910-964-4066
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Fax |
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Provider Business Mailing Address
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Address Line | 4706 ASHVILLE RD
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City | ASHVILLE
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State | NY
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Zip | 14710-9728
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Country | US
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Telephone | 910-964-4066
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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 | 225700000X
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Taxonomy Name | Massage Therapist
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License Number | 19812
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License Number State | NC
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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 | 15201
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License Number State | NC
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