MEDICARE: KATHLEEN RENEE BARTON 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	1502	CO

General Provider Information

NPI Number	:	1457006678
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	KATHLEEN RENEE BARTON COTA

Provider Business Mailing Address
First Line	:	300 RASPBERRY LN
Second Line	:
City	:	MONUMENT
State	:	CO
Zip	:	80132-7107
Country	:	US
Telephone Number	:	479-418-3689
Fax Number	:

Provider Business Practice Location Address
First Line	:	7600 SANDY ROCK PT
Second Line	:
City	:	COLORADO SPRINGS
State	:	CO
Zip	:	80924-5222
Country	:	US
Telephone Number	:	719-960-4005
Fax Number	:

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

Provider Enumeration Date	:	02/16/2022
Last Update Date	:	02/16/2022

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