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NPI Code Detail

MEDICARE: TAMMY COLLETTE MANNINO COTA

MEDICARE: TAMMY COLLETTE MANNINO 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 Assistant0131001991VA
2224Z00000XOccupational Therapy Assistant2414NC

General Provider Information

NPI Number : 1558607333
Entity Type Code : Individual
Provider Name (Legal Business Name) : TAMMY COLLETTE MANNINO COTA
Provider Business Mailing Address
First Line : 601 MONTREAT RD
Second Line :
City : BLACK MOUNTAIN
State : NC
Zip : 28711-3137
Country : US
Telephone Number : 352-638-6719
Fax Number :
Provider Business Practice Location Address
First Line : 75 FISHER LOOP
Second Line :
City : MAGGIE VALLEY
State : NC
Zip : 28751-5531
Country : US
Telephone Number : 828-566-3002
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 12/22/2012
Last Update Date : 04/18/2019

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