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NPI Code Detail

MEDICARE: DESTINY R SIMS COTA

MEDICARE: DESTINY R SIMS 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 AssistantOTA-047163AZ

General Provider Information

NPI Number : 1538913355
Entity Type Code : Individual
Provider Name (Legal Business Name) : DESTINY R SIMS COTA
Provider Business Mailing Address
First Line : 3045 W ROSE LANE
Second Line :
City : PHOENIX
State : AZ
Zip : 85017
Country : UM
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 1951 W CAMELBACK RD STE 450
Second Line :
City : PHOENIX
State : AZ
Zip : 85015-3474
Country : US
Telephone Number : 602-601-2401
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 04/16/2024
Last Update Date : 04/16/2024

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Directions to “ DESTINY R SIMS COTA” Practice Location

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