Provider Demographics
NPI:1124248000
Name:HUERTA, PATRICK (COTA)
Entity type:Individual
Prefix:MR
First Name:PATRICK
Middle Name:
Last Name:HUERTA
Suffix:
Gender:M
Credentials:COTA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:13398 OWENS RD
Mailing Address - Street 2:
Mailing Address - City:GREENWOOD
Mailing Address - State:DE
Mailing Address - Zip Code:19950-5537
Mailing Address - Country:US
Mailing Address - Phone:302-349-5421
Mailing Address - Fax:
Practice Address - Street 1:231 S WASHINGTON ST
Practice Address - Street 2:
Practice Address - City:MILLSBORO
Practice Address - State:DE
Practice Address - Zip Code:19966-1236
Practice Address - Country:US
Practice Address - Phone:302-934-7300
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-04-26
Last Update Date:2019-04-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDA00745224Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes224Z00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapy Assistant