Provider Demographics
NPI:1780464081
Name:COTTA, AIMEE RENAE
Entity type:Individual
Prefix:
First Name:AIMEE
Middle Name:RENAE
Last Name:COTTA
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:801 CHAMBORD WAY
Mailing Address - Street 2:
Mailing Address - City:HOLLY SPRINGS
Mailing Address - State:NC
Mailing Address - Zip Code:27540-9426
Mailing Address - Country:US
Mailing Address - Phone:209-534-4564
Mailing Address - Fax:
Practice Address - Street 1:801 CHAMBORD WAY
Practice Address - Street 2:
Practice Address - City:HOLLY SPRINGS
Practice Address - State:NC
Practice Address - Zip Code:27540-9426
Practice Address - Country:US
Practice Address - Phone:209-534-4564
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-10-03
Last Update Date:2024-09-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA35381235Z00000X
FLSA21787235Z00000X
NE2793235Z00000X
NC30003197235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist