Healthcare Provider Details

I. General information

NPI: 1235076175
Provider Name (Legal Business Name): SAMANTHA ARLENE ROSE COTA/L
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/29/2026
Last Update Date: 04/29/2026
Certification Date: 04/29/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

501 S HARMONY RD
NEWARK DE
19713-3338
US

IV. Provider business mailing address

400 BECKER AVE
WILMINGTON DE
19804-2102
US

V. Phone/Fax

Practice location:
  • Phone: 302-266-9255
  • Fax:
Mailing address:
  • Phone: 302-753-1040
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code224Z00000X
TaxonomyOccupational Therapy Assistant
License NumberU2-0001089
License Number StateDE

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: