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General NPI Number Information
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NPI Number | 1851042824
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Entity Type | Individual
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Provider Name | BAYLEE HUNTER LATTA COTA
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Gender | Female
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Dates
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Enumeration Date | 01/12/2022
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Last Update Date | 01/12/2022
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Provider Practice Location Address
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Address Line | 1653 MOORESVILLE HWY
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City | LEWISBURG
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State | TN
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Zip | 37091-1413
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Country | US
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Telephone | 931-359-4056
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Fax |
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Provider Business Mailing Address
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Address Line | 2613 MAPLEWOOD DR APT B
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City | COLUMBIA
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State | TN
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Zip | 38401-4340
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Country | US
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Telephone | 901-338-5118
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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 | 3562
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License Number State | TN
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