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NPI Code Detail

MEDICARE: MRS. JANAE MARIE HICKS COTA/L

MEDICARE: MRS. JANAE MARIE HICKS 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
1225X00000XOccupational Therapist9333NC

General Provider Information

NPI Number : 1750526497
Entity Type Code : Individual
Provider Name (Legal Business Name) : MRS. JANAE MARIE HICKS COTA/L
Provider Business Mailing Address
First Line : 13625 FAIRINGTON OAKS DRIVE
Second Line :
City : MINT HILL
State : NC
Zip : 28227
Country : US
Telephone Number : 607-857-6470
Fax Number :
Provider Business Practice Location Address
First Line : 8919 PARK RD
Second Line :
City : CHARLOTTE
State : NC
Zip : 28210-9600
Country : US
Telephone Number : 704-551-6800
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 12/10/2008
Last Update Date : 11/25/2014

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