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General NPI Number Information
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NPI Number | 1467754630
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Entity Type | Individual
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Provider Name | DOROTHY ELAINE PEARSON COTA
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Gender | Female
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Dates
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Enumeration Date | 11/22/2010
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Last Update Date | 11/22/2010
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Provider Practice Location Address
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Address Line | 500 S MAIN ST
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City | HOPE
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State | AR
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Zip | 71801-5206
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Country | US
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Telephone | 870-777-4501
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Fax |
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Provider Business Mailing Address
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Address Line | 409 FOREST
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City | TAYLOR
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State | AR
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Zip | 71861
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Country | US
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Telephone | 870-904-1309
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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-595
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License Number State | AR
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