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KIMBERLY BLACK COTA

>> Occupational Therapy Assistant >> Respiratory, Developmental, Rehabilitative and Restorative Service Providers

Registrant NPI Number: 1326415043

Individual Registrant:
 KIMBERLY  BLACK COTA
Gender: F
Not Sole Proprietor

Location and contact information for practice:
2403 BATTLEFIELD PKWY  FORT OGLETHORPE, GA 30742-4033 US
Tel: 706-866-7700  Fax: --

Contact information for business:
71 CLARK RD  TUNNEL HILL, GA 30755-6800 US
Tel: 423-463-6531  Fax: --

Registration Information:
NPI: 1326415043
Entity Type: Individual

Specialty information:

PrimaryCodeCategory/DescriptionStateLicense Number
Y224Z00000XRespiratory, Developmental, Rehabilitative and Restorative Service Providers
Occupational Therapy Assistant
GAOTA001922
N224Z00000XRespiratory, Developmental, Rehabilitative and Restorative Service Providers
Occupational Therapy Assistant
TN2530

Legacy codes, insurance codes and state license numbers:

IssuerNumberStateType




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