Healthcare Provider Details

I. General information

NPI: 1003217415
Provider Name (Legal Business Name): MEGAN ANNE KELLY COTA
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/05/2014
Last Update Date: 12/15/2025
Certification Date: 12/15/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

9300 DEWITT LOOP
FT BELVOIR VA
22060-5285
US

IV. Provider business mailing address

4201 31ST ST S APT 1002
ARLINGTON VA
22206-2194
US

V. Phone/Fax

Practice location:
  • Phone: 571-231-1321
  • Fax:
Mailing address:
  • Phone: 518-330-7955
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code224Z00000X
TaxonomyOccupational Therapy Assistant
License Number004481-1
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: