Provider Demographics
NPI:1962772954
Name:COTE, ANDREW MARTIN
Entity type:Individual
Prefix:MR
First Name:ANDREW
Middle Name:MARTIN
Last Name:COTE
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4417 MOSSY ROCK CT
Mailing Address - Street 2:
Mailing Address - City:LAS VEGAS
Mailing Address - State:NV
Mailing Address - Zip Code:89108-2951
Mailing Address - Country:US
Mailing Address - Phone:702-619-5699
Mailing Address - Fax:
Practice Address - Street 1:4417 MOSSY ROCK CT
Practice Address - Street 2:
Practice Address - City:LAS VEGAS
Practice Address - State:NV
Practice Address - Zip Code:89108-2951
Practice Address - Country:US
Practice Address - Phone:702-619-5699
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-01-06
Last Update Date:2012-01-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NV101YP1600X
225400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225400000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersRehabilitation Practitioner
No101YP1600XBehavioral Health & Social Service ProvidersCounselorPastoral