Individual
MIRANDA KOTT
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
1 DIANE DR, FORT ASHBY, WV 26719
(304) 298-3602
Mailing address
16711 DAVIS HOLLOW RD SE, OLDTOWN, MD 21555-1359
Taxonomy
Speciality
Code
Description
License number
State
224Z00000X
Occupational Therapy Assistant
Primary
C1893
WV
Other
Enumeration date
11/21/2014
Last updated
11/21/2014
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