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General NPI Number Information
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NPI Number | 1972111789
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Entity Type | Organization
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Legal Business Name | DEWAYNE COTTON
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Dates
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Enumeration Date | 07/17/2020
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Last Update Date | 02/22/2022
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Provider Practice Location Address
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Address Line | 5447 HAMPTON PL
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City | SAGINAW
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State | MI
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Zip | 48604-9284
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Country | US
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Telephone | 989-252-7044
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Fax |
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Provider Business Mailing Address
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Address Line | 4953 FONTAINE BLVD
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City | SAGINAW
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State | MI
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Zip | 48603-7812
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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 | BEHAVIOR TECHNICIAN
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Name | MR. DEWAYNE COTTON
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Credential |
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Telephone | 989-501-4362
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 106S00000X
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Taxonomy Name | Behavior Technician
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License Number |
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License Number State |
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