MEDICARE: KAYLA JEFFERSON COTA

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	OTA001158	GA

General Provider Information

NPI Number	:	1801208996
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	KAYLA JEFFERSON COTA

Provider Business Mailing Address
First Line	:	3100 GENTIAN BLVD STE 124
Second Line	:
City	:	COLUMBUS
State	:	GA
Zip	:	31907-5670
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	3100 GENTIAN BLVD STE 124
Second Line	:
City	:	COLUMBUS
State	:	GA
Zip	:	31907-5670
Country	:	US
Telephone Number	:	229-395-1710
Fax Number	:

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

Provider Enumeration Date	:	05/23/2014
Last Update Date	:	07/03/2025

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