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General NPI Number Information
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NPI Number | 1437701422
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Entity Type | Individual
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Provider Name | CECILIA DAVIS COTA/L
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Gender | Female
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Dates
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Enumeration Date | 07/10/2019
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Last Update Date | 07/10/2019
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Provider Practice Location Address
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Address Line | 6981 HIGHWAY 13
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City | ERIN
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State | TN
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Zip | 37061-4465
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Country | US
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Telephone | 931-289-4005
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Fax |
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Provider Business Mailing Address
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Address Line | 3446 BRADFIELD DR
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City | CLARKSVILLE
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State | TN
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Zip | 37042-8153
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Country | US
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Telephone | 915-244-6921
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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 | 3252
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License Number State | TN
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