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General NPI Number Information
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NPI Number | 1154882199
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Entity Type | Individual
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Provider Name | TRISHA ANN MEIER COTAL
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Gender | Female
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Dates
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Enumeration Date | 03/30/2019
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Last Update Date | 03/30/2019
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Provider Practice Location Address
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Address Line | 3270 PRATT LAKE RD
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City | GLADWIN
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State | MI
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Zip | 48624-8901
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Country | US
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Telephone | 989-426-7275
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Fax |
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Provider Business Mailing Address
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Address Line | 3183 HIGHLAND PKWY
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City | GLADWIN
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State | MI
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Zip | 48624-9212
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Country | US
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Telephone | 989-578-2426
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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 | 5202006202
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License Number State | MI
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