Healthcare Provider Details

I. General information

NPI: 1174260418
Provider Name (Legal Business Name): ANGELA CATHERINE CARLINI COTA/L
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/18/2022
Last Update Date: 05/18/2022
Certification Date: 05/18/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

925 BEAR CORBITT RD
BEAR DE
19701-1323
US

IV. Provider business mailing address

31 CHAMBORD DR
NEWARK DE
19702-5547
US

V. Phone/Fax

Practice location:
  • Phone: 302-454-2400
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225XP0200X
TaxonomyPediatric Occupational Therapist
License NumberU2-0012214
License Number StateDE

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: