Healthcare Provider Details

I. General information

NPI: 1831034685
Provider Name (Legal Business Name): ANGELA AUGUSTINE COTA/L
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/20/2026
Last Update Date: 04/20/2026
Certification Date: 04/20/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

24100 PALM DR
NORTH OLMSTED OH
44070-2844
US

IV. Provider business mailing address

35141 MILDRED ST APT B105
NORTH RIDGEVILLE OH
44039-1693
US

V. Phone/Fax

Practice location:
  • Phone: 440-588-5400
  • Fax:
Mailing address:
  • Phone: 440-588-5400
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code224Z00000X
TaxonomyOccupational Therapy Assistant
License NumberOTA008331
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: