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General NPI Number Information
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NPI Number | 1437322716
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Entity Type | Individual
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Provider Name | ANGELA MICHELLE STALLARD COTA/L
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Gender | Female
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Dates
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Enumeration Date | 04/08/2008
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Last Update Date | 04/08/2013
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Provider Practice Location Address
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Address Line | 165 COLEMAN AVE 11-B
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City | ASHEVILLE
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State | NC
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Zip | 28801-1386
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Country | US
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Telephone | 717-654-8155
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Fax |
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Provider Business Mailing Address
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Address Line | 165 COLEMAN AVENUE 11-B
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City | ASHEVILLE
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State | NC
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Zip | 28801
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Country | US
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Telephone | 717-654-8155
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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 | OP006485
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License Number State | PA
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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 | 7189
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License Number State | NC
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