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NPI Code Detail

MEDICARE: MRS. AUBREY VERMILLION COTA/L

MEDICARE: MRS. AUBREY VERMILLION 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 AssistantOT-A1348AR

General Provider Information

NPI Number : 1558091199
Entity Type Code : Individual
Provider Name (Legal Business Name) : MRS. AUBREY VERMILLION COTA/L
Provider Business Mailing Address
First Line : 8070 N TILLYS HILL RD
Second Line :
City : DECATUR
State : AR
Zip : 72722-9622
Country : US
Telephone Number : 479-802-8446
Fax Number :
Provider Business Practice Location Address
First Line : 650 S DODSON RD
Second Line :
City : ROGERS
State : AR
Zip : 72758-7015
Country : US
Telephone Number : 479-271-7120
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 06/15/2022
Last Update Date : 06/15/2022

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