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General NPI Number Information
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NPI Number | 1144998626
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Entity Type | Individual
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Provider Name | ALLYSON HARTMAN COTA/L
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Gender | Female
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Dates
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Enumeration Date | 08/31/2021
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Last Update Date | 08/31/2021
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Provider Practice Location Address
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Address Line | 489 S BOULDER HWY
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City | HENDERSON
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State | NV
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Zip | 89015
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Country | US
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Telephone | 702-224-2809
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Fax |
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Provider Business Mailing Address
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Address Line | 4100 S LINDSAY RD STE 113
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City | GILBERT
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State | AZ
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Zip | 85297-1507
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Country | US
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Telephone | 480-219-3953
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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 | OTA2239
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License Number State | NV
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