Most Relevant Information
Provider Data
| NPI Number: | 1003037136 |
| Provider Name: | LEISA MARIE HIDEY COTA |
| Entity Type: | Individual |
| Taxonomy Code: | 224Z00000X |
| Specialty: | Occupational Therapy Assistant |
| License Number: | A01399 |
Most Important Dates
| Enumeration Date: | 05/02/2007 |
| Last Updated: | 07/08/2007 |
Provider Practice Location
700 N. 40TH ST.
BALTIMORE
MD
21211
Practice Location Phone/Fax
| Phone: | 4102358860 |
| Fax: |
Provider Mailing Location
6203 WOODCREST DR.
ELLICOTT CITY
MD
21043
Provider Mailing Phone/Fax
| Phone: | 4103790194 |
| Fax: |