MEDICARE: CYNTHIA YORDON C.O.T.A.

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
1	224Z00000X	Occupational Therapy Assistant

General Provider Information

NPI Number	:	1104255975
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	CYNTHIA YORDON C.O.T.A.

Provider Business Mailing Address
First Line	:	1632 UKIAH LN
Second Line	:
City	:	FORT COLLINS
State	:	CO
Zip	:	80525-5308
Country	:	US
Telephone Number	:	970-310-9026
Fax Number	:

Provider Business Practice Location Address
First Line	:	1632 UKIAH LN
Second Line	:
City	:	FORT COLLINS
State	:	CO
Zip	:	80525-5308
Country	:	US
Telephone Number	:	970-310-9026
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	11/02/2013
Last Update Date	:	11/02/2013

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