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General NPI Number Information
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NPI Number | 1235074832
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Entity Type | Individual
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Provider Name | TAYLOR LYNN GADDY COTA
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Gender | Female
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Dates
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Enumeration Date | 04/21/2026
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Last Update Date | 04/21/2026
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Provider Practice Location Address
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Address Line | 817 N MOUND ST
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City | NACOGDOCHES
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State | TX
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Zip | 75961-4427
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Country | US
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Telephone | 936-564-6907
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Fax |
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Provider Business Mailing Address
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Address Line | 1124 ARCADIA RD
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City | CENTER
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State | TX
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Zip | 75935-7972
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Country | US
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Telephone | 936-488-0161
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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 | 217943
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License Number State | TX
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