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General NPI Number Information
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NPI Number | 1306009857
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Entity Type | Individual
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Provider Name | CHRISTINE RAVISH COTA/L
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Gender | Female
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Dates
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Enumeration Date | 07/04/2008
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Last Update Date | 07/04/2008
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Provider Practice Location Address
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Address Line | 95 LAUREL ST
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City | GREENFIELD
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State | MA
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Zip | 01301-3106
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Country | US
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Telephone | 413-774-3143
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Fax | 413-772-0478
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Provider Business Mailing Address
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Address Line | 65 S MILL RIVER RD
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City | SOUTH DEERFIELD
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State | MA
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Zip | 01373-9733
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Country | US
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Telephone |
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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 | 2733
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License Number State | MA
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