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General NPI Number Information
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NPI Number | 1730556655
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Entity Type | Individual
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Provider Name | JOHNACA DAWSON COTA/L
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Gender | Female
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Dates
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Enumeration Date | 08/26/2015
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Last Update Date | 02/12/2025
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Provider Practice Location Address
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Address Line | 3088 CENTERPOINT RD
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City | DECATUR
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State | TN
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Zip | 37322-4631
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Country | US
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Telephone | 423-368-5147
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Fax |
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Provider Business Mailing Address
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Address Line | 3088 CENTERPOINT RD
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City | DECATUR
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State | TN
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Zip | 37322-4631
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Country | US
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Telephone | 423-368-5147
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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 | 2542
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License Number State | TN
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