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NPI 1619253515

NPI 1619253515 : TRICIA LYNN ROBINSON COTA/L : FOUNTAIN INN, SC

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General NPI Number Information
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    NPI Number           |    1619253515
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    Entity Type          |    Individual 
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    Provider Name        |    TRICIA LYNN ROBINSON COTA/L
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    Gender               |    Female 
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Dates
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    Enumeration Date     |    10/24/2011
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    Last Update Date     |    10/24/2011
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Provider Practice Location Address
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    Address Line         |    201 HARTWICK LN 
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    City                 |    FOUNTAIN INN
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    State                |    SC
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    Zip                  |    29644-8023
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    Country              |    US
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    Telephone            |    864-770-5597
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    Fax                  |    864-409-1455
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Provider Business Mailing Address
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    Address Line         |    201 HARTWICK LN 
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    City                 |    FOUNTAIN INN
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    State                |    SC
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    Zip                  |    29644-8023
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    Country              |    US
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    Telephone            |    864-770-5597
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    Fax                  |    864-409-1455
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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        |    225XP0200X
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    Taxonomy Name        |    Pediatric Occupational Therapist
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    License Number       |    2942
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    License Number State |    SC
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