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General NPI Number Information
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NPI Number | 1477062354
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Entity Type | Individual
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Provider Name | REBEKAH ANNE WILSON COTA
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Gender | Female
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Dates
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Enumeration Date | 09/24/2017
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Last Update Date | 01/18/2019
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Provider Practice Location Address
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Address Line | 3223 SPRING CYPRESS RD APT 635
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City | SPRING
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State | TX
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Zip | 77388-4897
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Country | US
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Telephone | 903-754-9009
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Fax | 844-228-2099
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Provider Business Mailing Address
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Address Line | 4062 SUMMERHILL SQ
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City | TEXARKANA
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State | TX
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Zip | 75503-2730
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Country | US
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Telephone | 903-908-3839
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Fax | 844-228-2099
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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 | 214633
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License Number State | TX
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