Provider Demographics
NPI:1427562032
Name:COTTO, MARILIA (LMT)
Entity Type:Individual
Prefix:
First Name:MARILIA
Middle Name:
Last Name:COTTO
Suffix:
Gender:F
Credentials:LMT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1 TRAP FALLS RD STE 209
Mailing Address - Street 2:
Mailing Address - City:SHELTON
Mailing Address - State:CT
Mailing Address - Zip Code:06484-4698
Mailing Address - Country:US
Mailing Address - Phone:203-519-6912
Mailing Address - Fax:
Practice Address - Street 1:1 TRAP FALLS RD STE 209
Practice Address - Street 2:
Practice Address - City:SHELTON
Practice Address - State:CT
Practice Address - Zip Code:06484-4698
Practice Address - Country:US
Practice Address - Phone:203-225-6336
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-11-20
Last Update Date:2017-11-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT006185225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist