=====================================================
General NPI Number Information
=====================================================
NPI Number | 1457271439
-----------------------------------------------------
Entity Type | Individual
-----------------------------------------------------
Provider Name | MARIA MELBO COTA/L
-----------------------------------------------------
Gender | Female
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 07/20/2026
-----------------------------------------------------
Last Update Date | 07/20/2026
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 1717 UNIVERSITY DR SE
-----------------------------------------------------
City | SAINT CLOUD
-----------------------------------------------------
State | MN
-----------------------------------------------------
Zip | 56304-2023
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 320-251-9120
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 555 VICTORY AVE APT 204
-----------------------------------------------------
City | SARTELL
-----------------------------------------------------
State | MN
-----------------------------------------------------
Zip | 56377-4813
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone |
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position |
-----------------------------------------------------
Name |
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone |
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 224Z00000X
-----------------------------------------------------
Taxonomy Name | Occupational Therapy Assistant
-----------------------------------------------------
License Number | 202931
-----------------------------------------------------
License Number State | MN
-----------------------------------------------------