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General NPI Number Information
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NPI Number | 1740106475
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Entity Type | Individual
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Provider Name | MADISON VICTORIA RIDGELY COTA/L
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Gender | Female
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Dates
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Enumeration Date | 06/26/2026
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Last Update Date | 06/26/2026
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Provider Practice Location Address
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Address Line | 6655 SYKESVILLE RD
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City | SYKESVILLE
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State | MD
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Zip | 21784-7966
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Country | US
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Telephone | 410-970-7000
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Fax |
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Provider Business Mailing Address
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Address Line | 19 SMOKEHOUSE CT
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City | LITTLESTOWN
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State | PA
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Zip | 17340-1155
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Country | US
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Telephone |
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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 | 225XM0800X
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Taxonomy Name | Mental Health Occupational Therapist
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License Number | A02502
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License Number State | MD
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