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General NPI Number Information
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NPI Number | 1811154818
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Entity Type | Individual
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Provider Name | NICOLLE KASS COTA
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Gender | Female
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Dates
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Enumeration Date | 05/19/2008
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Last Update Date | 11/12/2024
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Provider Practice Location Address
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Address Line | 1105 CEDAR RD
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City | BOSCOBEL
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State | WI
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Zip | 53805-1761
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Country | US
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Telephone | 608-332-3602
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Fax |
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Provider Business Mailing Address
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Address Line | 3631 NAPOLI LN APT 2
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City | MIDDLETON
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State | WI
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Zip | 53562-2160
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Country | US
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Telephone |
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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 | 1989-027
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License Number State | WI
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