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General NPI Number Information
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NPI Number | 1396327532
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Entity Type | Individual
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Provider Name | MIRIAH CHELISE SIMPSON COTA/L, A.S
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Gender | Female
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Dates
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Enumeration Date | 04/27/2021
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Last Update Date | 03/15/2024
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Provider Practice Location Address
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Address Line | 7776 S POINTE PKWY W
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City | PHOENIX
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State | AZ
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Zip | 85044-5423
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Country | US
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Telephone | 480-518-7073
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Fax |
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Provider Business Mailing Address
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Address Line | 7776 S POINTE PKWY W
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City | PHOENIX
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State | AZ
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Zip | 85044-5423
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Country | US
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Telephone | 480-518-7073
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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 | OTA-050029
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License Number State | AZ
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