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General NPI Number Information
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NPI Number | 1851411250
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Entity Type | Individual
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Provider Name | HELEN LANANNE SMITHVALDIVIA COTA
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Gender | Female
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Dates
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Enumeration Date | 03/30/2007
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Last Update Date | 07/08/2007
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Provider Practice Location Address
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Address Line | 2100 W GIRARD AVE
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City | PHILADELPHIA
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State | PA
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Zip | 19130-1400
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Country | US
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Telephone | 215-685-0800
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Fax |
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Provider Business Mailing Address
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Address Line | 544 S 2ND ST
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City | DARBY
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State | PA
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Zip | 19023-3105
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Country | US
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Telephone | 610-586-4617
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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 | OP002180-L
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License Number State | PA
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