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General NPI Number Information
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NPI Number | 1508689936
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Entity Type | Individual
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Provider Name | ALEXANDRA ROBAUS COTA
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Gender | Female
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Dates
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Enumeration Date | 11/04/2024
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Last Update Date | 11/04/2024
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Provider Practice Location Address
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Address Line | 521 N WILLOW ST
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City | HARRISON
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State | AR
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Zip | 72601-3518
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Country | US
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Telephone | 870-280-3071
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Fax |
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Provider Business Mailing Address
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Address Line | 2671 US HIGHWAY 160
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City | WALNUT SHADE
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State | MO
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Zip | 65771-9212
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Country | US
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Telephone | 417-920-6514
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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 | 2021041799
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License Number State | MO
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Taxonomy #2
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Taxonomy Code | 224Z00000X
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Taxonomy Name | Occupational Therapy Assistant
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License Number | OT-A2071
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License Number State | AR
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