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1477713295 NPI number — BRENDA WARR COTA/L

NPI Number: 1477713295
Health Care Provider/Practitioner: BRENDA WARR COTA/L

Information about “1477713295” NPI (BRENDA WARR COTA/L) exists in 1477713295 in HTML format HTML  |  1477713295 in plain Text format TXT  |  1477713295 in PDF (Portable Document Format) PDF  |  1477713295 in an XML format XML  formats.

NPI Number : 1477713295 – JSON Data Format

                
{
  "Npi": {
    "NPI": "1477713295",
    "EntityType": "Individual",
    "ReplacementNPI": null,
    "EIN": null,
    "IsSoleProprietor": "N",
    "IsOrgSubpart": null,
    "ParentOrgLBN": null,
    "ParentOrgTIN": null,
    "OrgName": null,
    "LastName": "WARR",
    "FirstName": "BRENDA",
    "MiddleName": null,
    "NamePrefix": null,
    "NameSuffix": null,
    "Credential": "COTA/L",
    "OtherOrgName": null,
    "OtherOrgNameTypeCode": null,
    "OtherLastName": "MOCK",
    "OtherFirstName": "BRENDA",
    "OtherMiddleName": null,
    "OtherNamePrefix": null,
    "OtherNameSuffix": null,
    "OtherCredential": "COTA/L",
    "OtherLastNameTypeCode": "1",
    "FirstLineMailingAddress": "772 FALLING RUN RD",
    "SecondLineMailingAddress": null,
    "MailingAddressCityName": "BLAIRSVILLE",
    "MailingAddressStateName": "PA",
    "MailingAddressPostalCode": "15717-8142",
    "MailingAddressCountryCode": "US",
    "MailingAddressTelephoneNumber": "703-491-5338",
    "MailingAddressFaxNumber": null,
    "FirstLinePracticeLocationAddress": "14906 JEFFERSON DAVIS HWY",
    "SecondLinePracticeLocationAddress": null,
    "PracticeLocationAddressCityName": "WOODBRIDGE",
    "PracticeLocationAddressStateName": "VA",
    "PracticeLocationAddressPostalCode": "22191",
    "PracticeLocationAddressCountryCode": "US",
    "PracticeLocationAddressTelephoneNumber": "703-491-5338",
    "PracticeLocationAddressFaxNumber": null,
    "EnumerationDate": "06/16/2008",
    "LastUpdateDate": "06/16/2008",
    "NPIDeactivationReasonCode": null,
    "NPIDeactivationReason": null,
    "NPIDeactivationDate": null,
    "NPIReactivationDate": null,
    "GenderCode": "F",
    "Gender": "Female",
    "AuthorizedOfficialLastName": null,
    "AuthorizedOfficialFirstName": null,
    "AuthorizedOfficialMiddleName": null,
    "AuthorizedOfficialTitle": null,
    "AuthorizedOfficialNamePrefix": null,
    "AuthorizedOfficialNameSuffix": null,
    "AuthorizedOfficialCredential": null,
    "AuthorizedOfficialTelephoneNumber": null,
    "Taxonomies": {
      "Taxonomy": {
        "TaxonomyCode": "225X00000X",
        "TaxonomyName": "Occupational Therapist",
        "LicenseNumber": "OP006460",
        "LicenseNumberStateCode": "PA",
        "PrimaryTaxonomySwitch": "Y"
      }
    },
    "HealthcareProviderTaxonomyGroups": null
  }
}
                
            

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