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NPI Code Detail

MEDICARE: MRS. HELENE RENE' HANSON COTA/L

MEDICARE: MRS. HELENE RENE' HANSON 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 Assistant1659AZ

General Provider Information

NPI Number : 1295968592
Entity Type Code : Individual
Provider Name (Legal Business Name) : MRS. HELENE RENE' HANSON COTA/L
Provider Business Mailing Address
First Line : 5125 N 58TH AVE # VAE
Second Line :
City : GLENDALE
State : AZ
Zip : 85301-7453
Country : US
Telephone Number : 623-931-5800
Fax Number : 623-931-8776
Provider Business Practice Location Address
First Line : 5125 N 58TH AVE
Second Line :
City : GLENDALE
State : AZ
Zip : 85301-7453
Country : US
Telephone Number : 623-931-5800
Fax Number : 623-931-8776
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 09/02/2009
Last Update Date : 09/02/2009

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Directions to “ MRS. HELENE RENE' HANSON COTA/L” Practice Location

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