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General NPI Number Information
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NPI Number | 1346973971
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Entity Type | Individual
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Provider Name | STEPHANIE ADDINGTON IRVIN COTA
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Gender | Female
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Dates
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Enumeration Date | 07/01/2022
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Last Update Date | 07/01/2022
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Provider Practice Location Address
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Address Line | 154 AMENDMENT AVE STE 104
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City | ROCK HILL
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State | SC
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Zip | 29732-3156
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Country | US
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Telephone | 803-632-4565
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Fax |
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Provider Business Mailing Address
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Address Line | 1036 ORCHARD GROVES CT APT 102
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City | BELMONT
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State | NC
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Zip | 28012-4184
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Country | US
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Telephone | 704-954-4042
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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 | 5418
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License Number State | SC
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