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General NPI Number Information
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NPI Number | 1346012184
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Entity Type | Individual
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Provider Name | TINA ANN MARIE PITZER COTA,AND CNA
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Gender | Female
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Dates
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Enumeration Date | 10/25/2023
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Last Update Date | 10/25/2023
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Provider Practice Location Address
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Address Line | 700 S FREMONT ST
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City | PRAIRIE DU CHIEN
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State | WI
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Zip | 53821-2331
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Country | US
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Telephone | 608-326-8471
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Fax |
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Provider Business Mailing Address
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Address Line | 59006 DUCHARME RIDGE RD
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City | EASTMAN
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State | WI
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Zip | 54626-8170
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Country | US
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Telephone | 715-579-6260
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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 | 7105-27
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License Number State | WI
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