Provider Demographics
NPI:1881026748
Name:BROWN, LILEITH A (COTA)
Entity Type:Individual
Prefix:MRS
First Name:LILEITH
Middle Name:A
Last Name:BROWN
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 1:1980 TAYLOR DR.
Mailing Address - Street 2:APT 12
Mailing Address - City:WINCHESTER
Mailing Address - State:VA
Mailing Address - Zip Code:22601-6340
Mailing Address - Country:US
Mailing Address - Phone:573-821-2642
Mailing Address - Fax:
Practice Address - Street 1:1980 TAYLOR DR
Practice Address - Street 2:APT 12
Practice Address - City:WINCHESTER
Practice Address - State:VA
Practice Address - Zip Code:22601-6374
Practice Address - Country:US
Practice Address - Phone:573-821-2642
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-08-02
Last Update Date:2013-08-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0131001157224Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes224Z00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapy Assistant