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General NPI Number Information
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NPI Number | 1265666127
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Entity Type | Individual
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Provider Name | SHAYE GURRERA COTA
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Gender | Female
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Dates
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Enumeration Date | 05/06/2009
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Last Update Date | 05/06/2009
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Provider Practice Location Address
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Address Line | 2050 S MAIN ST
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City | DELTA
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State | CO
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Zip | 81416-2407
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Country | US
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Telephone | 970-874-9773
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Fax | 970-874-9755
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Provider Business Mailing Address
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Address Line | 512 WINDSOR LN LOT 56
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City | FOUNTAIN
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State | CO
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Zip | 80817-2083
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Country | US
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Telephone | 719-460-7587
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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 |
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License Number State |
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