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NPI Code Detail

MEDICARE: LISA BERNHARDT CERDA COTA/L

MEDICARE: LISA BERNHARDT CERDA 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 Assistant6582NC

General Provider Information

NPI Number : 1538516018
Entity Type Code : Individual
Provider Name (Legal Business Name) : LISA BERNHARDT CERDA COTA/L
Provider Business Mailing Address
First Line : 1505 BRINGLE FERRY RD
Second Line :
City : SALISBURY
State : NC
Zip : 28146-4776
Country : US
Telephone Number : 704-637-5885
Fax Number :
Provider Business Practice Location Address
First Line : 1505 BRINGLE FERRY RD
Second Line :
City : SALISBURY
State : NC
Zip : 28146-4776
Country : US
Telephone Number : 704-637-5885
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 05/16/2016
Last Update Date : 05/16/2016

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