Provider Demographics
NPI:1467047944
Name:GARWOOD, MENA LEARDI (COTA)
Entity Type:Individual
Prefix:
First Name:MENA
Middle Name:LEARDI
Last Name:GARWOOD
Suffix:
Gender:F
Credentials:COTA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:26304 CAMINO REAL
Mailing Address - Street 2:
Mailing Address - City:CARMEL
Mailing Address - State:CA
Mailing Address - Zip Code:93923-9241
Mailing Address - Country:US
Mailing Address - Phone:434-981-8805
Mailing Address - Fax:
Practice Address - Street 1:1575 SKYLINE DR
Practice Address - Street 2:
Practice Address - City:MONTEREY
Practice Address - State:CA
Practice Address - Zip Code:93940-4110
Practice Address - Country:US
Practice Address - Phone:831-373-2731
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-03-05
Last Update Date:2021-03-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0131002425224Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes224Z00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapy Assistant