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General NPI Number Information
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NPI Number | 1225512247
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Entity Type | Individual
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Provider Name | DANIELLE LORINDA BLASE COTA
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Gender | Female
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Dates
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Enumeration Date | 09/17/2018
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Last Update Date | 09/17/2018
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Provider Practice Location Address
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Address Line | 19205 PEARL RD APT 203
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City | STRONGSVILLE
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State | OH
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Zip | 44136-6903
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Country | US
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Telephone | 440-219-8324
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Fax |
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Provider Business Mailing Address
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Address Line | 2220 GRANTWOOD DR
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City | PARMA
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State | OH
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Zip | 44134-4012
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Country | US
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Telephone | 216-965-4236
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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 | OTA006969
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License Number State | OH
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