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General NPI Number Information
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NPI Number | 1194697714
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Entity Type | Individual
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Provider Name | TEAGAN MARCOUILLER COTA
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Gender | Female
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Dates
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Enumeration Date | 09/22/2025
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Last Update Date | 09/22/2025
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Provider Practice Location Address
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Address Line | 323 W MONROE ST
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City | WYOCENA
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State | WI
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Zip | 53969-7168
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Country | US
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Telephone | 608-429-2181
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Fax |
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Provider Business Mailing Address
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Address Line | 203 6TH ST
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City | WAUNAKEE
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State | WI
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Zip | 53597-1631
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Country | US
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Telephone | 608-440-0302
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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 | 539194
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License Number State | WI
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