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General NPI Number Information
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NPI Number | 1326460213
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Entity Type | Individual
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Provider Name | MONICA COYAZO COTA/L
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Gender | Female
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Dates
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Enumeration Date | 01/10/2014
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Last Update Date | 01/10/2014
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Provider Practice Location Address
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Address Line | 1211 HAWAII AVE
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City | ALAMOGORDO
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State | NM
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Zip | 88310-6437
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Country | US
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Telephone | 575-812-5994
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Fax |
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Provider Business Mailing Address
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Address Line | 2160 STARDUST CT APT 6
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City | ALAMOGORDO
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State | NM
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Zip | 88310-3354
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Country | US
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Telephone | 575-430-1546
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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 | 1630
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License Number State | NM
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