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General NPI Number Information
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NPI Number | 1922196419
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Entity Type | Individual
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Provider Name | AUDRA ROCHELLE LAMBERS COTA
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Gender | Female
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Dates
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Enumeration Date | 10/10/2006
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Last Update Date | 07/08/2007
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Provider Practice Location Address
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Address Line | 100 E VINE ST
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City | MURFREESBORO
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State | TN
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Zip | 37130-3734
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Country | US
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Telephone | 615-289-0202
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Fax | 615-248-1400
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Provider Business Mailing Address
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Address Line | 1417 SAVANNAH PARK DR
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City | SPRING HILL
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State | TN
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Zip | 37174-7171
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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 | 005778
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License Number State | TN
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