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General NPI Number Information
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NPI Number | 1679441109
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Entity Type | Individual
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Provider Name | DANIEL ESTRADA COTA/L
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Gender | Male
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Dates
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Enumeration Date | 10/27/2025
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Last Update Date | 10/27/2025
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Provider Practice Location Address
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Address Line | 700 HOWIE MINE RD
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City | WAXHAW
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State | NC
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Zip | 28173-9715
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Country | US
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Telephone | 704-243-7640
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Fax |
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Provider Business Mailing Address
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Address Line | 2008 SLIPPERY ROCK LN
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City | MONROE
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State | NC
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Zip | 28112-0010
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Country | US
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Telephone | 732-519-1582
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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 | 18025
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License Number State | NC
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