Most Relevant Information
Provider Data
| NPI Number: | 1003233172 |
| Provider Name: | ANNETTE ANGELA BACA COTA/L |
| Entity Type: | Individual |
| Taxonomy Code: | 224Z00000X |
| Specialty: | Occupational Therapy Assistant |
| License Number: | 3073 |
Most Important Dates
| Enumeration Date: | 03/26/2014 |
| Last Updated: | 03/26/2014 |
Provider Practice Location
520 N MAIN ST
BELEN
NM
870023720
Practice Location Phone/Fax
| Phone: | 5059661104 |
| Fax: |
Provider Mailing Location
520 N MAIN ST
BELEN
NM
870023720
Provider Mailing Phone/Fax
| Phone: | 5059661104 |
| Fax: |