Healthcare Provider Details

I. General information

NPI: 1073450409
Provider Name (Legal Business Name): MEERA YANZ COTA/L
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 05/04/2026
Last Update Date: 05/04/2026
Certification Date: 05/03/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

170 ROSE AVE W
SAINT PAUL MN
55117-4437
US

IV. Provider business mailing address

4815 28TH AVE S APT 318
MINNEAPOLIS MN
55417-1357
US

V. Phone/Fax

Practice location:
  • Phone: 651-350-7655
  • Fax: 651-386-0013
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code224Z00000X
TaxonomyOccupational Therapy Assistant
License Number201348
License Number StateMN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: