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NPI Code Detail

MEDICARE: CAROLE ANN CAPUTA COTA

MEDICARE:   CAROLE ANN CAPUTA  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 Assistant200764MN

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1200764OTHERMNMN LICENSE
2AA510909OTHERMNNBCOT CERTIFICATION

General Provider Information

NPI Number : 1083925697
Entity Type Code : Individual
Provider Name (Legal Business Name) : CAROLE ANN CAPUTA COTA
Provider Business Mailing Address
First Line : 3153 OLD HIGHWAY 8
Second Line : #309A
City : ST ANTHONY
State : MN
Zip : 55418-2583
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 14301 EWING AVE S
Second Line :
City : BURNSVILLE
State : MN
Zip : 55306-4885
Country : US
Telephone Number : 952-746-5350
Fax Number : 952-746-6131
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 06/29/2010
Last Update Date : 06/29/2010

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Directions to “ CAROLE ANN CAPUTA COTA” Practice Location

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