Basic Information
Provider Information
NPI: 1306117379
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: COX
FirstName: EMILY
MiddleName:  
NamePrefix:  
NameSuffix:  
Credential: COTA/L
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
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OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: 6590 TRYON RD
Address2:  
City: CARY
State: NC
PostalCode: 275187052
CountryCode: US
TelephoneNumber: 9198518000
FaxNumber:  
Practice Location
Address1: 6590 TRYON RD
Address2:  
City: CARY
State: NC
PostalCode: 275187052
CountryCode: US
TelephoneNumber: 9198518000
FaxNumber:  
Other Information
ProviderEnumerationDate: 01/23/2012
LastUpdateDate: 01/23/2012
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: F
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate:  

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
224Z00000X6562NCY Respiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapy Assistant 

No ID Information.


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