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General NPI Number Information
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NPI Number | 1104775535
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Entity Type | Individual
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Provider Name | KEILA FRASER COTA/L
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Gender | Female
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Dates
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Enumeration Date | 01/27/2026
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Last Update Date | 01/27/2026
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Provider Practice Location Address
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Address Line | 14366 SOMMERVILLE CT
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City | MIDLOTHIAN
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State | VA
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Zip | 23113-6838
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Country | US
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Telephone | 804-601-4733
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Fax |
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Provider Business Mailing Address
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Address Line | 2210 GREY OAK DR
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City | NORTH CHESTERFIELD
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State | VA
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Zip | 23236-5278
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Country | US
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Telephone | 804-247-0177
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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 | 0131000383
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License Number State | VA
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