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General NPI Number Information
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NPI Number | 1356535652
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Entity Type | Individual
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Provider Name | YVETTE JANENE FORBES COTA/L
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Gender | Female
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Dates
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Enumeration Date | 08/29/2007
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Last Update Date | 08/29/2007
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Provider Practice Location Address
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Address Line | 4562 LAWRENCEVILLE HWY NW SUITE 201
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City | LILBURN
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State | GA
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Zip | 30047-3618
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Country | US
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Telephone | 770-806-4136
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Fax | 770-806-4139
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Provider Business Mailing Address
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Address Line | CAREER STAFF UNLIMITED-ATLANTA ALLIED 4562 LAWRENCEVILLE HIGHWAY SUITE 201
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City | LILBURN
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State | GA
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Zip | 30047
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Country | US
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Telephone | 770-806-4136
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Fax | 770-806-4139
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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 | A00236
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License Number State | GA
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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 | 2752
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License Number State | AL
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