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NPI Code Detail

MEDICARE: MS. DIANA MARIE CLARKE COTA

MEDICARE: MS. DIANA MARIE CLARKE COTA
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1224Z00000XOccupational Therapy Assistant1033TN

General Provider Information

NPI Number : 1013039031
Entity Type Code : Individual
Provider Name (Legal Business Name) : MS. DIANA MARIE CLARKE COTA
Provider Business Mailing Address
First Line : 1463 KINGWOOD LN
Second Line :
City : ROCKVALE
State : TN
Zip : 37153-4078
Country : US
Telephone Number : 615-907-8008
Fax Number :
Provider Business Practice Location Address
First Line : 420 N UNIVERSITY ST
Second Line :
City : MURFREESBORO
State : TN
Zip : 37130-3931
Country : US
Telephone Number : 615-893-2619
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 04/03/2007
Last Update Date : 07/08/2007

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