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General NPI Number Information
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NPI Number | 1477432540
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Entity Type | Individual
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Provider Name | MAKENNA KATHRYN USKO COTA
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Gender | Female
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Dates
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Enumeration Date | 09/02/2025
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Last Update Date | 09/04/2025
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Provider Practice Location Address
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Address Line | 205 N TERRACE ST APT 2
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City | SALMON
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State | ID
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Zip | 83467-4137
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Country | US
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Telephone | 614-893-0942
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Fax |
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Provider Business Mailing Address
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Address Line | 205 N TERRACE ST APT 2
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City | SALMON
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State | ID
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Zip | 83467-4137
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Country | US
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Telephone |
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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 | OT-2025-0152
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License Number State | NM
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