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General NPI Number Information
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NPI Number | 1083187322
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Entity Type | Individual
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Provider Name | ANNETTE VALDEZ COTA/L
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Gender | Female
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Dates
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Enumeration Date | 01/09/2019
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Last Update Date | 01/09/2019
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Provider Practice Location Address
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Address Line | 2445 ARMY NAVY DR STE 304
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City | ARLINGTON
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State | VA
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Zip | 22206-2905
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Country | US
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Telephone | 562-253-7351
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Fax |
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Provider Business Mailing Address
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Address Line | 11555 OLDE TIVERTON CIR APT 35-201
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City | RESTON
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State | VA
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Zip | 20194-1913
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Country | US
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Telephone | 562-253-7351
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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 | 0131-002120
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License Number State | VA
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