Healthcare Provider Details

I. General information

NPI: 1922913094
Provider Name (Legal Business Name): ANDRIA MAINS COTA/L
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/14/2026
Last Update Date: 08/14/2026
Certification Date: 08/14/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4975 OSTER RD
SHEFFIELD VILLAGE OH
44054-1561
US

IV. Provider business mailing address

4253 VILAMOURA DR
AVON OH
44011-3753
US

V. Phone/Fax

Practice location:
  • Phone: 440-949-4234
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code224Z00000X
TaxonomyOccupational Therapy Assistant
License Number008760
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: