Provider Demographics
NPI:1730944521
Name:COTTON, TANGELIA DANETTE
Entity type:Individual
Prefix:
First Name:TANGELIA
Middle Name:DANETTE
Last Name:COTTON
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:721 HARRY TRUMAN DR APT 412
Mailing Address - Street 2:
Mailing Address - City:UPPER MARLBORO
Mailing Address - State:MD
Mailing Address - Zip Code:20774-2091
Mailing Address - Country:US
Mailing Address - Phone:240-351-0360
Mailing Address - Fax:
Practice Address - Street 1:721 HARRY TRUMAN DR APT 412
Practice Address - Street 2:
Practice Address - City:UPPER MARLBORO
Practice Address - State:MD
Practice Address - Zip Code:20774-2091
Practice Address - Country:US
Practice Address - Phone:240-351-0360
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-02-20
Last Update Date:2024-02-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251B00000XAgenciesCase Management