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General NPI Number Information
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NPI Number | 1508078395
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Entity Type | Individual
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Provider Name | LORRAINE SIMMONS COTA
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Gender | Female
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Dates
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Enumeration Date | 05/04/2007
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Last Update Date | 07/08/2007
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Provider Practice Location Address
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Address Line | 8128 FLORIDA BLVD
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City | DENHAM SPRINGS
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State | LA
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Zip | 70726
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Country | US
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Telephone | 225-791-8666
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Fax | 225-791-2891
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Provider Business Mailing Address
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Address Line | 34386 HIGHWAY 43
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City | INDEPENDENCE
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State | LA
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Zip | 70443
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Country | US
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Telephone | 985-878-3642
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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 | OTAZ20491
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License Number State | LA
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