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General NPI Number Information
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NPI Number | 1104304369
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Entity Type | Individual
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Provider Name | BROOKE MARIE FRANKLIN COTA
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Gender | Female
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Dates
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Enumeration Date | 07/31/2018
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Last Update Date | 07/31/2018
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Provider Practice Location Address
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Address Line | 6710 OXON HILL RD
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City | OXON HILL
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State | MD
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Zip | 20745-1117
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Country | US
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Telephone | 301-238-5290
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Fax |
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Provider Business Mailing Address
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Address Line | 1821 BATTERY LN
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City | OWINGS
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State | MD
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Zip | 20736-3142
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Country | US
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Telephone | 601-870-0618
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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 | 1052611
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License Number State |
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