MEDICARE: LISA PINET LAFEHR 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
1	224Z00000X	Occupational Therapy Assistant

General Provider Information

NPI Number	:	1376873026
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	LISA PINET LAFEHR COTA

Provider Business Mailing Address
First Line	:	3330 SUNNINGDALE PL
Second Line	:
City	:	FORT COLLINS
State	:	CO
Zip	:	80525-2859
Country	:	US
Telephone Number	:	970-217-6921
Fax Number	:

Provider Business Practice Location Address
First Line	:	3330 SUNNINGDALE PL
Second Line	:
City	:	FORT COLLINS
State	:	CO
Zip	:	80525-2859
Country	:	US
Telephone Number	:	970-217-6921
Fax Number	:

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

Provider Enumeration Date	:	12/31/2009
Last Update Date	:	03/25/2011

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