MEDICARE: KAYLA MICHELLE MORGAN 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
1	224Z00000X	Occupational Therapy Assistant	2013002541	MO

General Provider Information

NPI Number	:	1639943293
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	KAYLA MICHELLE MORGAN COTA/L

Provider Business Mailing Address
First Line	:	26071 ROUTE A
Second Line	:
City	:	HOLLIDAY
State	:	MO
Zip	:	65258-2018
Country	:	US
Telephone Number	:	660-346-1999
Fax Number	:

Provider Business Practice Location Address
First Line	:	1010 US HIGHWAY 24 AND 36 E
Second Line	:
City	:	MONROE CITY
State	:	MO
Zip	:	63456-1116
Country	:	US
Telephone Number	:	660-346-1999
Fax Number	:

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

Provider Enumeration Date	:	11/14/2023
Last Update Date	:	11/14/2023

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