Provider Demographics
NPI:1518156462
Name:COTTO, NICOLE ELLEN (B ED)
Entity Type:Individual
Prefix:
First Name:NICOLE
Middle Name:ELLEN
Last Name:COTTO
Suffix:
Gender:F
Credentials:B ED
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:326 HOPE LOOP
Mailing Address - Street 2:
Mailing Address - City:EUGENE
Mailing Address - State:OR
Mailing Address - Zip Code:97402-1898
Mailing Address - Country:US
Mailing Address - Phone:541-337-0918
Mailing Address - Fax:
Practice Address - Street 1:995 W 7TH AVE
Practice Address - Street 2:
Practice Address - City:EUGENE
Practice Address - State:OR
Practice Address - Zip Code:97402-4611
Practice Address - Country:US
Practice Address - Phone:541-302-9195
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-10-16
Last Update Date:2007-11-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health