MEDICARE: MS. ANNE-MARIE HANZES 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	OP005969	PA

General Provider Information

NPI Number	:	1689923476
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MS. ANNE-MARIE HANZES COTA/L

Provider Business Mailing Address
First Line	:	4048 ELIZA ST.
Second Line	:
City	:	WEST MIFFLIN
State	:	PA
Zip	:	15221-2037
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	4048 ELIZA ST.
Second Line	:
City	:	WEST MIFFLIN
State	:	PA
Zip	:	15221-2037
Country	:	US
Telephone Number	:	412-476-8717
Fax Number	:

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

Provider Enumeration Date	:	09/07/2012
Last Update Date	:	09/07/2012

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