Healthcare Provider Details

I. General information

NPI: 1437082930
Provider Name (Legal Business Name): ALONDRA SILVA PADUA COTA/L
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/04/2026
Last Update Date: 06/04/2026
Certification Date: 06/04/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

145 S MAIN ST STE 4
WAYLAND MI
49348-1702
US

IV. Provider business mailing address

511 MAETHY ST SE
GRAND RAPIDS MI
49548-1221
US

V. Phone/Fax

Practice location:
  • Phone: 269-792-2353
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code224Z00000X
TaxonomyOccupational Therapy Assistant
License Number5202010355
License Number StateMI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: