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General NPI Number Information
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NPI Number | 1780536268
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Entity Type | Individual
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Provider Name | LATECE WILLIAMS COTA/L
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Gender | Male
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Dates
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Enumeration Date | 02/09/2026
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Last Update Date | 02/09/2026
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Provider Practice Location Address
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Address Line | 519 PERKINS RD
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City | PALMETTO
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State | GA
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Zip | 30268-2374
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Country | US
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Telephone | 770-463-2460
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Fax |
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Provider Business Mailing Address
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Address Line | 5520 CASCADE RUN SW
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City | ATLANTA
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State | GA
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Zip | 30336-4409
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Country | US
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Telephone | 706-728-5534
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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 | OTA001833
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License Number State | GA
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