Healthcare Provider Details

I. General information

NPI: 1437060837
Provider Name (Legal Business Name): MEGAN DAVIS COTA/L
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 09/15/2026
Last Update Date: 09/15/2026
Certification Date: 09/15/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4895 FAYETTEVILLE RD STE A
LUMBERTON NC
28358-2162
US

IV. Provider business mailing address

4895 FAYETTEVILLE RD STE A
LUMBERTON NC
28358-2162
US

V. Phone/Fax

Practice location:
  • Phone: 910-618-9807
  • Fax: 910-618-9216
Mailing address:
  • Phone: 910-618-9807
  • Fax: 910-618-9216

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code224Z00000X
TaxonomyOccupational Therapy Assistant
License Number11049
License Number StateNC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: