Healthcare Provider Details

I. General information

NPI: 1255457040
Provider Name (Legal Business Name): JOAN LOUISE ADAMS COTA
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 03/22/2007
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

520 KERR AVE
DENTON MD
21629-1343
US

IV. Provider business mailing address

5142 AMERICAN CORNER ROAD
FEDERALSBURG MD
21632
US

V. Phone/Fax

Practice location:
  • Phone: 410-479-2130
  • Fax:
Mailing address:
  • Phone: 410-479-2130
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code224Z00000X
TaxonomyOccupational Therapy Assistant
License NumberAOO776
License Number StateMD

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: