Provider Demographics
NPI:1447963079
Name:COTHEN, BIANCA MARIA (CPM)
Entity type:Individual
Prefix:
First Name:BIANCA
Middle Name:MARIA
Last Name:COTHEN
Suffix:
Gender:F
Credentials:CPM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:16 SPAULDING LN
Mailing Address - Street 2:
Mailing Address - City:HOLLIS
Mailing Address - State:NH
Mailing Address - Zip Code:03049-6512
Mailing Address - Country:US
Mailing Address - Phone:617-417-0323
Mailing Address - Fax:
Practice Address - Street 1:16 SPAULDING LN
Practice Address - Street 2:
Practice Address - City:HOLLIS
Practice Address - State:NH
Practice Address - Zip Code:03049-6512
Practice Address - Country:US
Practice Address - Phone:617-417-0323
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-12-28
Last Update Date:2022-12-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NH1078175M00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes175M00000XOther Service ProvidersMidwife, LayGroup - Single Specialty