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General NPI Number Information
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NPI Number | 1669138251
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Entity Type | Individual
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Provider Name | MARY JANE CHARLENE ATMOSFERA RIGUERA COTA/L
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Gender | Female
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Dates
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Enumeration Date | 11/09/2021
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Last Update Date | 11/09/2021
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Provider Practice Location Address
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Address Line | 100 WHIPPOORWILL LN
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City | CHAPEL HILL
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State | NC
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Zip | 27517-8505
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Country | US
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Telephone | 919-942-4014
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Fax |
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Provider Business Mailing Address
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Address Line | 1105 W NC HIGHWAY 54 BYP APT Y1
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City | CHAPEL HILL
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State | NC
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Zip | 27516-2866
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Country | US
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Telephone | 571-830-8648
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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 | 13876
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License Number State | NC
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