MEDICARE: MRS. ASHLEY SUE GUZOWSKI 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
1	224Z00000X	Occupational Therapy Assistant	5202006899	MI

General Provider Information

NPI Number	:	1174783443
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MRS. ASHLEY SUE GUZOWSKI COTA

Provider Business Mailing Address
First Line	:	1523 US HIGHWAY 2
Second Line	:
City	:	CRYSTAL FALLS
State	:	MI
Zip	:	49920-9633
Country	:	US
Telephone Number	:	906-874-1422
Fax Number	:

Provider Business Practice Location Address
First Line	:	1523 US HIGHWAY 2
Second Line	:
City	:	CRYSTAL FALLS
State	:	MI
Zip	:	49920-9633
Country	:	US
Telephone Number	:	906-874-1422
Fax Number	:	906-874-1442

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

Provider Enumeration Date	:	06/11/2008
Last Update Date	:	06/11/2008

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