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General NPI Number Information
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NPI Number | 1326319583
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Entity Type | Individual
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Provider Name | COLLEEN M RICE COTA
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Gender | Female
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Dates
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Enumeration Date | 01/19/2012
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Last Update Date | 01/19/2012
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Provider Practice Location Address
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Address Line | 4554 W. 48TH STREET
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City | FREMONT
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State | MI
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Zip | 49412
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Country | UM
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Telephone | 231-924-9295
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Fax |
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Provider Business Mailing Address
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Address Line | 1846 BENSTON
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City | WHITEHALL
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State | MI
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Zip | 49461
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Country | US
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Telephone | 231-894-6259
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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 | 225X00000X
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Taxonomy Name | Occupational Therapist
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License Number | 5202006968
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License Number State | MI
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