MEDICARE: PATRICIA LOUISE BROWN 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
1	224Z00000X	Occupational Therapy Assistant	057000382	IL
2	224Z00000X	Occupational Therapy Assistant	004804	MO

General Provider Information

NPI Number	:	1316228752
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	PATRICIA LOUISE BROWN COTA/L

Provider Business Mailing Address
First Line	:	4941 LINDENWOOD AVE
Second Line	:
City	:	SAINT LOUIS
State	:	MO
Zip	:	63109-1820
Country	:	US
Telephone Number	:	314-856-3898
Fax Number	:

Provider Business Practice Location Address
First Line	:	6260 LOUGHBOROUGH AVE
Second Line	:
City	:	SAINT LOUIS
State	:	MO
Zip	:	63109-3629
Country	:	US
Telephone Number	:	314-856-3898
Fax Number	:

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

Provider Enumeration Date	:	08/30/2011
Last Update Date	:	12/19/2023

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