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General NPI Number Information
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NPI Number | 1215054887
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Entity Type | Individual
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Provider Name | DONNA LAVAE WARD COTA
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Gender | Female
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Dates
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Enumeration Date | 03/26/2007
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Last Update Date | 07/08/2007
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Provider Practice Location Address
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Address Line | 5500 W 9TH AVE
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City | AMARILLO
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State | TX
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Zip | 79106-4100
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Country | US
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Telephone | 806-468-1030
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Fax |
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Provider Business Mailing Address
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Address Line | 3509 LANGTRY DR
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City | AMARILLO
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State | TX
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Zip | 79109-3923
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Country | US
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Telephone | 806-358-1568
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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 | 208046
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License Number State | TX
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