Healthcare Provider Details

I. General information

NPI: 1023955366
Provider Name (Legal Business Name): CAITLIN MICHELLE DEFREHN COTA
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: CAIT DEFREHN

II. Dates (important events)

Enumeration Date: 05/04/2026
Last Update Date: 05/04/2026
Certification Date: 05/04/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8815 COLUMBIA 100 PKWY STE 4-5
COLUMBIA MD
21045-2361
US

IV. Provider business mailing address

2221 WESTFIELD AVE
BALTIMORE MD
21214-1052
US

V. Phone/Fax

Practice location:
  • Phone: 877-776-8502
  • Fax:
Mailing address:
  • Phone: 609-618-8057
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code224Z00000X
TaxonomyOccupational Therapy Assistant
License NumberA03269
License Number StateMD

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: