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NPI Code Detail

MEDICARE: MADISYN LENORA PATTERSON COTA/L

MEDICARE: MADISYN LENORA PATTERSON 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
1224Z00000XOccupational Therapy Assistant13513NC
2106S00000XBehavior Technician

General Provider Information

NPI Number : 1952820151
Entity Type Code : Individual
Provider Name (Legal Business Name) : MADISYN LENORA PATTERSON COTA/L
Provider Business Mailing Address
First Line : 500 FAIRWAY DR STE 102
Second Line :
City : DEERFIELD BCH
State : FL
Zip : 33441-1817
Country : US
Telephone Number : 888-880-9270
Fax Number :
Provider Business Practice Location Address
First Line : 7022 SARDIS RD
Second Line :
City : CHARLOTTE
State : NC
Zip : 28270-6058
Country : US
Telephone Number : 704-366-8260
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 09/19/2017
Last Update Date : 01/24/2021

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