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General NPI Number Information
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NPI Number | 1558509091
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Entity Type | Individual
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Provider Name | LAURIE MARIE CARR COTA
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Gender | Female
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Dates
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Enumeration Date | 01/21/2009
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Last Update Date | 01/21/2009
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Provider Practice Location Address
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Address Line | 4895 PINE RIDGE DR
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City | COLUMBUS
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State | IN
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Zip | 47201-2569
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Country | US
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Telephone | 812-342-3098
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Fax |
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Provider Business Mailing Address
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Address Line | 2111 UNION ST
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City | COLUMBUS
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State | IN
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Zip | 47201-4243
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Country | US
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Telephone | 812-390-5201
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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 | 32000573A
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License Number State | IN
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