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NPI Code Detail

MEDICARE: LORI ELLEN SANDEN COTA

MEDICARE: LORI ELLEN SANDEN 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 Assistant5202002270MI

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
15202002270OTHERMICERTIFIED OCCUPATIONAL THERAPY ASSISTANT

General Provider Information

NPI Number : 1477028967
Entity Type Code : Individual
Provider Name (Legal Business Name) : LORI ELLEN SANDEN COTA
Provider Business Mailing Address
First Line : 157 APPLEWOOD CT
Second Line :
City : DAVISON
State : MI
Zip : 48423-9137
Country : US
Telephone Number : 269-788-4307
Fax Number :
Provider Business Practice Location Address
First Line : 13137 N CLIO RD
Second Line :
City : CLIO
State : MI
Zip : 48420-1028
Country : US
Telephone Number : 810-686-2600
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 10/10/2018
Last Update Date : 10/10/2018

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Directions to “ LORI ELLEN SANDEN COTA” Practice Location

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