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General NPI Number Information
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NPI Number | 1265919419
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Entity Type | Individual
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Provider Name | LESLIE COLLINS COTA/L
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Gender | Female
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Dates
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Enumeration Date | 07/20/2018
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Last Update Date | 05/06/2020
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Provider Practice Location Address
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Address Line | 5034 NEWFOREST DR APT 8309
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City | SAN ANTONIO
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State | TX
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Zip | 78229-5468
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Country | US
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Telephone | 832-274-5911
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Fax |
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Provider Business Mailing Address
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Address Line | 12701 WEST AVE APT 712
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City | SAN ANTONIO
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State | TX
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Zip | 78216-1863
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Country | US
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Telephone | 501-428-8204
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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 | OT-A1382
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License Number State | AR
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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 | 216131
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License Number State | TX
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