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General NPI Number Information
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NPI Number | 1295257186
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Entity Type | Individual
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Provider Name | HEIDI ANN CORWIN COTA
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Gender | Female
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Dates
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Enumeration Date | 07/12/2017
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Last Update Date | 07/12/2017
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Provider Practice Location Address
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Address Line | 60 BRIMLEY DR
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City | FREDERICKSBURG
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State | VA
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Zip | 22406-5148
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Country | US
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Telephone | 540-479-3788
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Fax |
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Provider Business Mailing Address
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Address Line | 9109 SNOWY EGRET CT
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City | SPOTSYLVANIA
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State | VA
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Zip | 22553-3659
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Country | US
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Telephone | 540-538-9882
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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 |
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License Number State |
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