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General NPI Number Information
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NPI Number | 1063909927
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Entity Type | Individual
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Provider Name | MELANIE HINES COTA/L
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Gender | Female
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Dates
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Enumeration Date | 04/17/2018
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Last Update Date | 04/17/2018
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Provider Practice Location Address
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Address Line | 1215 INDUSTRIAL AVE
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City | DANVILLE
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State | VA
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Zip | 24541-3145
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Country | US
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Telephone | 434-799-6400
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Fax |
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Provider Business Mailing Address
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Address Line | 2268 LEVEL RUN RD
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City | HURT
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State | VA
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Zip | 24563-3383
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Country | US
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Telephone |
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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 | 224Z00000X
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Taxonomy Name | Occupational Therapy Assistant
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License Number | 0131000357
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License Number State | VA
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