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General NPI Number Information
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NPI Number | 1437797511
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Entity Type | Individual
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Provider Name | MICHCHALONDA THOMPSON COTA
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Gender | Female
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Dates
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Enumeration Date | 12/19/2019
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Last Update Date | 12/19/2019
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Provider Practice Location Address
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Address Line | 616 GREEN HOUSE WAY
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City | CARMEL
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State | IN
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Zip | 46032-3178
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Country | US
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Telephone | 317-401-8888
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Fax |
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Provider Business Mailing Address
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Address Line | 8136 BRAEBURN TER
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City | INDIANAPOLIS
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State | IN
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Zip | 46219-2549
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Country | US
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Telephone | 317-833-0106
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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 | 32002748A
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License Number State | IN
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