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General NPI Number Information
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NPI Number | 1043868490
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Entity Type | Individual
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Provider Name | TARA JONES COTA
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Gender | Female
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Dates
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Enumeration Date | 08/29/2019
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Last Update Date | 08/29/2019
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Provider Practice Location Address
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Address Line | 410 E MACPHAIL RD
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City | BEL AIR
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State | MD
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Zip | 21014-4410
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Country | US
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Telephone | 410-420-6144
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Fax |
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Provider Business Mailing Address
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Address Line | 4182 FLINTVILLE RD
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City | DARLINGTON
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State | MD
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Zip | 21034-1139
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Country | US
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Telephone | 443-616-6965
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 225X00000X
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Taxonomy Name | Occupational Therapist
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License Number | A02090
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License Number State | MD
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