MEDICARE: MRS. AMANDA ARRINGTON 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	1421	OK

General Provider Information

NPI Number	:	1770977159
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MRS. AMANDA ARRINGTON COTA/L

Provider Business Mailing Address
First Line	:	7616 MEADOW LAKE DR
Second Line	:
City	:	YUKON
State	:	OK
Zip	:	73099-9793
Country	:	US
Telephone Number	:	405-952-7597
Fax Number	:

Provider Business Practice Location Address
First Line	:	7616 MEADOW LAKE DR
Second Line	:
City	:	YUKON
State	:	OK
Zip	:	73099-9793
Country	:	US
Telephone Number	:	405-952-7597
Fax Number	:

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

Provider Enumeration Date	:	03/24/2015
Last Update Date	:	03/24/2015

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