MEDICARE: MRS. KARI ANNE SCOTT 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	32001636A	IN

General Provider Information

NPI Number	:	1477717619
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MRS. KARI ANNE SCOTT COTA

Provider Business Mailing Address
First Line	:	3755 CENTERSTONE PKWY
Second Line	:
City	:	NEW HAVEN
State	:	IN
Zip	:	46774-2279
Country	:	US
Telephone Number	:	260-748-4546
Fax Number	:

Provider Business Practice Location Address
First Line	:	2510 E DUPONT RD STE 237
Second Line	:
City	:	FORT WAYNE
State	:	IN
Zip	:	46825-1603
Country	:	US
Telephone Number	:	260-490-6535
Fax Number	:

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

Provider Enumeration Date	:	07/16/2008
Last Update Date	:	12/14/2016

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