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NPI Code Detail

MEDICARE: SAMANTHA MILLER COTA/L

MEDICARE: SAMANTHA MILLER COTA/L
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1224Z00000XOccupational Therapy AssistantOP009724PA
2224Z00000XOccupational Therapy Assistant46TA09186600NJ
3224Z00000XOccupational Therapy Assistant0131003078VA

General Provider Information

NPI Number : 1023656360
Entity Type Code : Individual
Provider Name (Legal Business Name) : SAMANTHA MILLER COTA/L
Provider Business Mailing Address
First Line : 4454 OLD SQUAW LN
Second Line :
City : GLOUCESTER
State : VA
Zip : 23061-3644
Country : US
Telephone Number : 908-914-2984
Fax Number :
Provider Business Practice Location Address
First Line : 1062 W MERCURY BLVD # B
Second Line :
City : HAMPTON
State : VA
Zip : 23666-1068
Country : US
Telephone Number : 757-644-0644
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 12/17/2019
Last Update Date : 06/16/2025

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