Provider Demographics
NPI:1639688815
Name:COX, ALYSSA DAWN (COTA/L)
Entity Type:Individual
Prefix:
First Name:ALYSSA
Middle Name:DAWN
Last Name:COX
Suffix:
Gender:F
Credentials:COTA/L
Other - Prefix:
Other - First Name:ALYSSA
Other - Middle Name:DAWN
Other - Last Name:MILTON
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:COTA/L
Mailing Address - Street 1:37 BIRCH DR
Mailing Address - Street 2:
Mailing Address - City:HONAKER
Mailing Address - State:VA
Mailing Address - Zip Code:24260-1817
Mailing Address - Country:US
Mailing Address - Phone:276-210-1324
Mailing Address - Fax:
Practice Address - Street 1:196 CUMBERLAND RD
Practice Address - Street 2:
Practice Address - City:CEDAR BLUFF
Practice Address - State:VA
Practice Address - Zip Code:24609-1137
Practice Address - Country:US
Practice Address - Phone:276-964-6702
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-09-20
Last Update Date:2021-01-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0131001870224Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes224Z00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapy Assistant