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NPI Code Detail

MEDICARE: MRS. SUSAN HARMENING COTA/L

MEDICARE: MRS. SUSAN HARMENING COTA/L
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 Assistant000683GA

General Provider Information

NPI Number : 1083958458
Entity Type Code : Individual
Provider Name (Legal Business Name) : MRS. SUSAN HARMENING COTA/L
Provider Business Mailing Address
First Line : 4 KEEL PT
Second Line :
City : SAVANNAH
State : GA
Zip : 31419-9590
Country : US
Telephone Number : 678-612-8553
Fax Number :
Provider Business Practice Location Address
First Line : 127 CARTER ST
Second Line :
City : RICHMOND HILL
State : GA
Zip : 31324-3753
Country : US
Telephone Number : 912-756-6131
Fax Number : 912-756-6246
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 11/25/2012
Last Update Date : 11/25/2012

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