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NPI Code Detail

MEDICARE: KELLIE ALANA MAYFIELD COTA

MEDICARE: KELLIE ALANA MAYFIELD 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
1224Z00000XOccupational Therapy Assistant212252TX

General Provider Information

NPI Number : 1427539808
Entity Type Code : Individual
Provider Name (Legal Business Name) : KELLIE ALANA MAYFIELD COTA
Provider Business Mailing Address
First Line : 2551 HENRETTA PL
Second Line :
City : INGLESIDE
State : TX
Zip : 78362-6124
Country : US
Telephone Number : 361-813-7312
Fax Number :
Provider Business Practice Location Address
First Line : 3922 W RIVER DR
Second Line :
City : CORPUS CHRISTI
State : TX
Zip : 78410-5725
Country : US
Telephone Number : 361-767-2000
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 08/24/2018
Last Update Date : 08/24/2018

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Directions to “ KELLIE ALANA MAYFIELD COTA” Practice Location

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