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NPI Code Detail

MEDICARE: ASPEN ANGELICA MILLAN COTA/L

MEDICARE: ASPEN ANGELICA MILLAN COTA/L
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1224Z00000XOccupational Therapy AssistantOTA-050196AZ

General Provider Information

NPI Number : 1538008636
Entity Type Code : Individual
Provider Name (Legal Business Name) : ASPEN ANGELICA MILLAN COTA/L
Provider Business Mailing Address
First Line : 3142 W MELVIN ST
Second Line :
City : PHOENIX
State : AZ
Zip : 85009-4230
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 11811 N TATUM BLVD STE 3031
Second Line :
City : PHOENIX
State : AZ
Zip : 85028-1621
Country : US
Telephone Number : 602-708-9412
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 03/25/2026
Last Update Date : 03/25/2026

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Directions to “ ASPEN ANGELICA MILLAN COTA/L” Practice Location

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