Provider Demographics
NPI:1356719066
Name:ANDERSON, DENISE (COTA)
Entity type:Individual
Prefix:
First Name:DENISE
Middle Name:
Last Name:ANDERSON
Suffix:
Gender:F
Credentials:COTA
Other - Prefix:
Other - First Name:DENISE
Other - Middle Name:
Other - Last Name:BATTS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:2402 MELISSA ANN CT
Mailing Address - Street 2:
Mailing Address - City:KISSIMMEE
Mailing Address - State:FL
Mailing Address - Zip Code:34746-3595
Mailing Address - Country:US
Mailing Address - Phone:757-575-8925
Mailing Address - Fax:
Practice Address - Street 1:2402 MELISSA ANN CT
Practice Address - Street 2:
Practice Address - City:KISSIMMEE
Practice Address - State:FL
Practice Address - Zip Code:34746-3595
Practice Address - Country:US
Practice Address - Phone:757-575-8925
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2015-09-11
Last Update Date:2015-09-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLOTA11870224Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes224Z00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapy Assistant