Healthcare Provider Details

I. General information

NPI: 1619638830
Provider Name (Legal Business Name): SARAH LYNN HOWARD COTAL
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 01/10/2022
Last Update Date: 01/10/2022
Certification Date: 01/10/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

33300 UTICA RD
FRASER MI
48026-2017
US

IV. Provider business mailing address

44201 DEQUINDRE RD
TROY MI
48085-1117
US

V. Phone/Fax

Practice location:
  • Phone: 586-293-3300
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code224Z00000X
TaxonomyOccupational Therapy Assistant
License Number5202008158
License Number StateMI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: