MEDICARE: WILLIAM D PENNER 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	2505	NM

General Provider Information

NPI Number	:	1366714917
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	WILLIAM D PENNER COTA/L

Provider Business Mailing Address
First Line	:	3734 PIEDRAS NEGRAS DR
Second Line	:
City	:	LAS CRUCES
State	:	NM
Zip	:	88012-7671
Country	:	US
Telephone Number	:	575-642-0920
Fax Number	:

Provider Business Practice Location Address
First Line	:	3734 PIEDRAS NEGRAS DR
Second Line	:
City	:	LAS CRUCES
State	:	NM
Zip	:	88012-7671
Country	:	US
Telephone Number	:	575-642-0920
Fax Number	:

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

Provider Enumeration Date	:	01/29/2012
Last Update Date	:	01/29/2012

Similar Medicare Providers

1831550649 — RIVERS ASSOCIATES LLC
Practice Location Address:

3726 PIEDRAS NEGRAS DR
LAS CRUCES, NM
88012-7671

Practice Phone: 575-640-0578
Practice Fax:

1275471336 — DEL-REY PHARMACY LLC
Practice Location Address:

3291 DEL REY BLVD STE 3
LAS CRUCES, NM
88012-5045

Practice Phone: 575-888-4756
Practice Fax: 575-652-4519

1396693305 — NEW LEAF THERAPY SERVICES LLC
Practice Location Address:

4537 RED MOUNTAIN CIR
LAS CRUCES, NM
88012-5122

Practice Phone: 575-805-7844
Practice Fax:

1083427611 — BIPOC AND SEXUALITY CENTER
Practice Location Address:

4915 BERYL ST
LAS CRUCES, NM
88012-9425

Practice Phone: 575-312-2705
Practice Fax:

1306368873 — ELIZABETH ANN HAND RBT, BCBA
Practice Location Address:

3621 MARION LN
LAS CRUCES, NM
88012-7579

Practice Phone: 404-780-3242
Practice Fax:

1417395708 — YURI J KOPP RN, MSN, NP-C
Practice Location Address:

3751 DEL REY BLVD
LAS CRUCES, NM
88012-8526

Practice Phone: 575-382-6697
Practice Fax:

Directions to “ WILLIAM D PENNER COTA/L” Practice Location

Language	Start Address	Practice Location

These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

Copyright © 2007-2026 (Powered by Swiss Vault Engine), all rights reserved. HIPAA liability, trademark, document use and software licensing rules apply. All registered trademarks, used in the content, are the property of their owners. Your interactions with this site are in accordance with our Terms of Use and Privacy Policy.