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NPI Code Detail

MEDICARE: LUCRETIA DIONNE BROWN COTA

MEDICARE: LUCRETIA DIONNE BROWN 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 Assistant572CA
2224Z00000XOccupational Therapy Assistant209690TX

General Provider Information

NPI Number : 1558889295
Entity Type Code : Individual
Provider Name (Legal Business Name) : LUCRETIA DIONNE BROWN COTA
Provider Business Mailing Address
First Line : 1801 N GREENVILLE AVE APT 3341
Second Line :
City : RICHARDSON
State : TX
Zip : 75081-1611
Country : US
Telephone Number : 214-516-1831
Fax Number :
Provider Business Practice Location Address
First Line : 1010 EMERALD ISLE DR
Second Line :
City : DALLAS
State : TX
Zip : 75218-3980
Country : US
Telephone Number : 214-516-1838
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 09/01/2017
Last Update Date : 09/01/2017

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