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General NPI Number Information
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NPI Number | 1861976672
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Entity Type | Individual
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Provider Name | ELIZABETH ANN QUINN COTA
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Gender | Female
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Dates
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Enumeration Date | 09/18/2018
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Last Update Date | 09/18/2018
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Provider Practice Location Address
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Address Line | 1050 GRAND BLVD
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City | BOERNE
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State | TX
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Zip | 78006-9242
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Country | US
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Telephone | 830-816-4105
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Fax | 830-816-4101
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Provider Business Mailing Address
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Address Line | 1307 SHAWANEE PASS ST
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City | SAN ANTONIO
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State | TX
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Zip | 78260-2041
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Country | US
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Telephone | 830-980-9185
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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 | 212763
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License Number State | TX
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