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General NPI Number Information
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NPI Number | 1790239044
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Entity Type | Individual
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Provider Name | CHERYL LOHMAN COTA/L
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Gender | Female
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Dates
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Enumeration Date | 08/03/2016
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Last Update Date | 08/03/2016
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Provider Practice Location Address
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Address Line | 101 BRUCEWOOD RD
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City | SOUTHERN PINES
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State | NC
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Zip | 28387-5159
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Country | US
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Telephone | 910-246-2091
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Fax |
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Provider Business Mailing Address
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Address Line | 54 INLET VW
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City | SANFORD
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State | NC
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Zip | 27332-6187
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Country | US
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Telephone | 937-260-0881
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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 | 10468
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License Number State | NC
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