Provider Demographics
NPI:1497574271
Name:DEANDA, MARTHA LAURA (COTA)
Entity type:Individual
Prefix:
First Name:MARTHA
Middle Name:LAURA
Last Name:DEANDA
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 1:8430 N 23RD LN
Mailing Address - Street 2:
Mailing Address - City:MCALLEN
Mailing Address - State:TX
Mailing Address - Zip Code:78504-6249
Mailing Address - Country:US
Mailing Address - Phone:956-493-4593
Mailing Address - Fax:
Practice Address - Street 1:6316 N 10TH ST
Practice Address - Street 2:
Practice Address - City:MCALLEN
Practice Address - State:TX
Practice Address - Zip Code:78504-3599
Practice Address - Country:US
Practice Address - Phone:956-972-0404
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-10-08
Last Update Date:2024-10-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes224Z00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapy Assistant