Healthcare Provider Details

I. General information

NPI: 1326593690
Provider Name (Legal Business Name): LAURA MARIA CUCINOTTA MS, OTR
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/16/2016
Last Update Date: 08/16/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1200 1ST ST NE
WASHINGTON DC
20002-3361
US

IV. Provider business mailing address

3201 LANDOVER ST #1412
ALEXANDRIA VA
22305-1944
US

V. Phone/Fax

Practice location:
  • Phone: 202-442-5026
  • Fax:
Mailing address:
  • Phone: 508-577-0924
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225X00000X
TaxonomyOccupational Therapist
License NumberOT010001229
License Number StateDC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: