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NPI Code Detail

MEDICARE: MRS. STEPHANIE W MCEWEN COTAL

MEDICARE: MRS. STEPHANIE W MCEWEN COTAL
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 Assistant4342NC

General Provider Information

NPI Number : 1720102502
Entity Type Code : Individual
Provider Name (Legal Business Name) : MRS. STEPHANIE W MCEWEN COTAL
Provider Business Mailing Address
First Line : 7509 CHOUDER LN
Second Line :
City : WAKE FOREST
State : NC
Zip : 27587-5410
Country : US
Telephone Number : 919-570-0249
Fax Number :
Provider Business Practice Location Address
First Line : 300 MEADOWLAND DR
Second Line :
City : HILLSBOROUGH
State : NC
Zip : 27278-8502
Country : US
Telephone Number : 919-644-6714
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 03/19/2007
Last Update Date : 07/08/2007

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