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General NPI Number Information
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NPI Number | 1346922200
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Entity Type | Individual
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Provider Name | DAVAH LAWSON HEADRICK COTA/L
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Gender | Female
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Dates
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Enumeration Date | 08/01/2023
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Last Update Date | 08/01/2023
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Provider Practice Location Address
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Address Line | 11832 ROCK LANDING DR STE 105
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City | NEWPORT NEWS
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State | VA
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Zip | 23606-4261
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Country | US
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Telephone | 757-455-5000
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Fax |
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Provider Business Mailing Address
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Address Line | 200 RIDGE RD
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City | POQUOSON
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State | VA
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Zip | 23662-1830
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Country | US
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Telephone | 910-619-8082
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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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