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NPI Code Detail

MEDICARE: VICKI MELLEN COTA

MEDICARE: VICKI MELLEN COTA
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 Assistant0131001509VA

General Provider Information

NPI Number : 1518312297
Entity Type Code : Individual
Provider Name (Legal Business Name) : VICKI MELLEN COTA
Provider Business Mailing Address
First Line : 5000 FAIRBANKS AVE
Second Line :
City : ALEXANDRIA
State : VA
Zip : 22311-1246
Country : US
Telephone Number : 202-779-2204
Fax Number :
Provider Business Practice Location Address
First Line : 5000 FAIRBANKS AVE
Second Line :
City : ALEXANDRIA
State : VA
Zip : 22311-1246
Country : US
Telephone Number : 202-779-2204
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 04/29/2016
Last Update Date : 04/29/2016

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Directions to “ VICKI MELLEN COTA” Practice Location

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