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NPI Code Detail

MEDICARE: MRS. TANYAA SHAREE WILLIAMS COTA

MEDICARE: MRS. TANYAA SHAREE WILLIAMS 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 Assistant1076780VA

General Provider Information

NPI Number : 1265556906
Entity Type Code : Individual
Provider Name (Legal Business Name) : MRS. TANYAA SHAREE WILLIAMS COTA
Provider Business Mailing Address
First Line : 1013 CATHEDRAL DR
Second Line :
City : SUFFOLK
State : VA
Zip : 23434-8182
Country : US
Telephone Number : 757-539-1719
Fax Number :
Provider Business Practice Location Address
First Line : 4560 PRINCESS ANNE RD
Second Line :
City : VIRGINIA BEACH
State : VA
Zip : 23462-7905
Country : US
Telephone Number : 757-474-1249
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 03/19/2007
Last Update Date : 07/08/2007

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