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NPI Code Detail

MEDICARE: DANIELLE MARIE GATTON COTA

MEDICARE: DANIELLE MARIE GATTON 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
1224Z00000XOccupational Therapy Assistant2040-027WI

General Provider Information

NPI Number : 1942497029
Entity Type Code : Individual
Provider Name (Legal Business Name) : DANIELLE MARIE GATTON COTA
Provider Business Mailing Address
First Line : 1415 WISCONSIN ST
Second Line :
City : OSHKOSH
State : WI
Zip : 54901-2872
Country : US
Telephone Number : 920-312-0185
Fax Number :
Provider Business Practice Location Address
First Line : 725 BUTLER AVE
Second Line :
City : OSHKOSH
State : WI
Zip : 54901-8149
Country : US
Telephone Number : 920-235-5100
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 10/02/2007
Last Update Date : 10/02/2007

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