Provider Demographics
NPI:1982849717
Name:COTA, SUSAN KIMBERLY (CRT)
Entity Type:Individual
Prefix:MRS
First Name:SUSAN
Middle Name:KIMBERLY
Last Name:COTA
Suffix:
Gender:F
Credentials:CRT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9029 E SUGAR SUMAC ST
Mailing Address - Street 2:
Mailing Address - City:TUCSON
Mailing Address - State:AZ
Mailing Address - Zip Code:85747-5326
Mailing Address - Country:US
Mailing Address - Phone:520-971-3723
Mailing Address - Fax:
Practice Address - Street 1:9029 E SUGAR SUMAC ST
Practice Address - Street 2:
Practice Address - City:TUCSON
Practice Address - State:AZ
Practice Address - Zip Code:85747-5326
Practice Address - Country:US
Practice Address - Phone:520-971-3723
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-12-08
Last Update Date:2008-12-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ005604227800000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes227800000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersRespiratory Therapist, Certified