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General NPI Number Information
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NPI Number | 1104176437
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Entity Type | Individual
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Provider Name | TIFFANY L JOHNSON COTA/L
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Gender | Female
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Dates
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Enumeration Date | 09/13/2012
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Last Update Date | 10/10/2025
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Provider Practice Location Address
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Address Line | 1785 S HAYES ST
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City | ARLINGTON
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State | VA
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Zip | 22202
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Country | US
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Telephone | 703-920-5700
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Fax |
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Provider Business Mailing Address
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Address Line | 2228 RIDING CROP WAY
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City | WINDSOR MILL
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State | MD
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Zip | 21244-1261
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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 | A00626
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License Number State | MD
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Taxonomy #2
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Taxonomy Code | 224Z00000X
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Taxonomy Name | Occupational Therapy Assistant
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License Number | 0131000069
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License Number State | VA
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