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General NPI Number Information
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NPI Number | 1710619168
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Entity Type | Individual
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Provider Name | MEGAN CHRISTINA YOUNG COTA
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Gender | Female
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Dates
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Enumeration Date | 06/25/2022
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Last Update Date | 06/25/2022
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Provider Practice Location Address
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Address Line | 568 N PINE RD
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City | BAY CITY
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State | MI
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Zip | 48708-9190
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Country | US
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Telephone | 989-778-1713
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Fax |
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Provider Business Mailing Address
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Address Line | 1831 DOROTHY CIR LOT 82
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City | ESSEXVILLE
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State | MI
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Zip | 48732-9418
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Country | US
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Telephone | 989-280-0851
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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 | 5202007787
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License Number State | MI
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