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General NPI Number Information
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NPI Number | 1326807538
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Entity Type | Individual
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Provider Name | MAUREEN K EAGAN COTA/L
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Gender | Female
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Dates
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Enumeration Date | 03/18/2024
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Last Update Date | 03/30/2024
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Provider Practice Location Address
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Address Line | 232 S HEMLOCK RD
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City | HEMLOCK
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State | MI
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Zip | 48626-8784
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Country | US
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Telephone | 989-751-3371
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Fax |
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Provider Business Mailing Address
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Address Line | 1201 HARRIS AVE
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City | TAWAS CITY
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State | MI
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Zip | 48763-9680
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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 |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 224Z00000X
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Taxonomy Name | Occupational Therapy Assistant
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License Number | 5202009864
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License Number State | MI
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