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General NPI Number Information
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NPI Number | 1548001944
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Entity Type | Individual
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Provider Name | KARINNA SIERRA COTA/L
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Gender | Female
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Dates
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Enumeration Date | 06/01/2024
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Last Update Date | 11/20/2024
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Provider Practice Location Address
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Address Line | 5151 E BROADWAY BLVD STE 1500
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City | TUCSON
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State | AZ
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Zip | 85711-3787
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Country | US
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Telephone | 480-787-5387
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Fax | 866-701-4982
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Provider Business Mailing Address
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Address Line | 9150 W INDIAN SCHOOL RD STE 130
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City | PHOENIX
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State | AZ
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Zip | 85037-2388
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Country | US
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Telephone | 480-787-5387
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Fax | 623-232-3250
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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 | OTA-046612
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License Number State | AZ
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Taxonomy #2
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Taxonomy Code | 2080P0006X
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Taxonomy Name | Developmental - Behavioral Pediatrics Physician
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License Number | OTA-046612
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License Number State | AZ
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