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NPI Code Detail

MEDICARE: MRS. SHARON MATHIS COTA/L

MEDICARE: MRS. SHARON MATHIS 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 Assistant5363NC

General Provider Information

NPI Number : 1427282862
Entity Type Code : Individual
Provider Name (Legal Business Name) : MRS. SHARON MATHIS COTA/L
Provider Business Mailing Address
First Line : 1925 DAPHNE CIR
Second Line :
City : FAYETTEVILLE
State : NC
Zip : 28304-4764
Country : US
Telephone Number : 910-916-5465
Fax Number :
Provider Business Practice Location Address
First Line : 325 N COOL SPRING ST
Second Line :
City : FAYETTEVILLE
State : NC
Zip : 28301-5137
Country : US
Telephone Number : 910-484-7660
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 05/13/2009
Last Update Date : 04/22/2014

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