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General NPI Number Information
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NPI Number | 1811382211
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Entity Type | Individual
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Provider Name | AMBER DAWN CARTER COTA
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Gender | Female
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Dates
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Enumeration Date | 04/02/2015
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Last Update Date | 04/02/2015
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Provider Practice Location Address
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Address Line | 5800 E SKELLY DR STE 402
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City | TULSA
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State | OK
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Zip | 74135-6441
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Country | US
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Telephone | 918-497-1068
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Fax | 918-497-1069
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Provider Business Mailing Address
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Address Line | 100784 S 3540 RD
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City | SPARKS
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State | OK
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Zip | 74869-1002
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Country | US
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Telephone | 918-694-7301
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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 | 1294
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License Number State | OK
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