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NPI Code Detail

MEDICARE: JESSICA HOLT COTA/L

MEDICARE: JESSICA HOLT 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 Assistant2042CA
2224Z00000XOccupational Therapy AssistantOC60450841WA
3224Z00000XOccupational Therapy AssistantOTP-OTA-LIC-8614MT

General Provider Information

NPI Number : 1285053843
Entity Type Code : Individual
Provider Name (Legal Business Name) : JESSICA HOLT COTA/L
Provider Business Mailing Address
First Line : 25117 SW PARKWAY AVE STE D
Second Line :
City : WILSONVILLE
State : OR
Zip : 97070-9697
Country : US
Telephone Number : 412-721-9337
Fax Number :
Provider Business Practice Location Address
First Line : 1301 E BROADWAY ST
Second Line :
City : MISSOULA
State : MT
Zip : 59802-4905
Country : US
Telephone Number : 412-721-9337
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 04/10/2014
Last Update Date : 12/17/2021

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Directions to “ JESSICA HOLT COTA/L” Practice Location

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