MEDICARE: KATHY PESCADOR 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	OTA-3445	NV

General Provider Information

NPI Number	:	1558198820
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	KATHY PESCADOR COTA

Provider Business Mailing Address
First Line	:	6027 AMBLESHIRE AVE
Second Line	:
City	:	LAS VEGAS
State	:	NV
Zip	:	89139-6223
Country	:	US
Telephone Number	:	619-471-4829
Fax Number	:

Provider Business Practice Location Address
First Line	:	1525 E WINDMILL LN
Second Line	:
City	:	LAS VEGAS
State	:	NV
Zip	:	89123-1902
Country	:	US
Telephone Number	:	702-508-9325
Fax Number	:

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

Provider Enumeration Date	:	09/19/2024
Last Update Date	:	09/19/2024

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Directions to “ KATHY PESCADOR COTA” Practice Location

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