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NPI Code Detail

MEDICARE: TAMARA MARIE MORRIS COTA

MEDICARE:   TAMARA MARIE MORRIS  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 Assistant057.000352IL

General Provider Information

NPI Number : 1265046213
Entity Type Code : Individual
Provider Name (Legal Business Name) : TAMARA MARIE MORRIS COTA
Provider Business Mailing Address
First Line : 1211 PENNSYLVANIA AVE
Second Line :
City : MENDOTA
State : IL
Zip : 61342-1534
Country : US
Telephone Number : 815-761-9318
Fax Number :
Provider Business Practice Location Address
First Line : 1201 1ST AVE
Second Line :
City : MENDOTA
State : IL
Zip : 61342-1815
Country : US
Telephone Number : 800-397-1313
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 09/06/2020
Last Update Date : 09/06/2020

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Directions to “ TAMARA MARIE MORRIS COTA” Practice Location

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