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General NPI Number Information
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NPI Number | 1235916792
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Entity Type | Individual
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Provider Name | NICHOLAS COLE COTA/L, CAPS
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Gender | Male
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Dates
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Enumeration Date | 09/08/2023
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Last Update Date | 09/08/2023
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Provider Practice Location Address
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Address Line | 9370 WINDSOR LAKE BLVD
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City | COLUMBIA
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State | SC
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Zip | 29223-1995
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Country | US
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Telephone | 803-699-1121
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Fax |
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Provider Business Mailing Address
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Address Line | 360 RUTLEDGE PL
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City | COLUMBIA
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State | SC
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Zip | 29212-3134
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Country | US
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Telephone | 803-413-1301
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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 | 224ZF0002X
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Taxonomy Name | Feeding, Eating & Swallowing Occupational Therapy Assistant
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License Number | 3660
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License Number State | SC
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Taxonomy #2
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Taxonomy Code | 224ZL0004X
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Taxonomy Name | Low Vision Occupational Therapy Assistant
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License Number | 3660
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License Number State | SC
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Taxonomy #3
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Taxonomy Code | 224ZR0403X
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Taxonomy Name | Driving and Community Mobility Occupational Therapy Assistant
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License Number | 3660
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License Number State | SC
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Taxonomy #4
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Taxonomy Code | 224Z00000X
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Taxonomy Name | Occupational Therapy Assistant
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License Number | 3660
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License Number State | SC
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