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General NPI Number Information
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NPI Number | 1568343077
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Entity Type | Individual
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Provider Name | DESIREE DAVIS COTA
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Gender | Female
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Dates
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Enumeration Date | 09/10/2025
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Last Update Date | 09/10/2025
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Provider Practice Location Address
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Address Line | 2090 4TH ST
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City | BAKER CITY
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State | OR
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Zip | 97814-3318
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Country | US
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Telephone | 541-524-2260
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Fax |
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Provider Business Mailing Address
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Address Line | 1521 WASHINGTON AVE
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City | BAKER CITY
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State | OR
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Zip | 97814-2814
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Country | US
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Telephone | 541-403-2294
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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 | 481077
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License Number State | OR
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