Healthcare Provider Details

I. General information

NPI: 1447734173
Provider Name (Legal Business Name): MS. SARRA LEE COTTLE
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: SARRA HILL COTTLE

II. Dates (important events)

Enumeration Date: 09/19/2018
Last Update Date: 09/15/2026
Certification Date: 09/15/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

100 SCHOOL CIR
BURNSVILLE NC
28714-2623
US

IV. Provider business mailing address

392 ADAIRS RUN RD
PRINCETON WV
24739-9285
US

V. Phone/Fax

Practice location:
  • Phone: 828-682-6101
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225XP0200X
TaxonomyPediatric Occupational Therapist
License Number14112
License Number StateNC
# 2
Primary TaxonomyN
Taxonomy Code225X00000X
TaxonomyOccupational Therapist
License Number0119007841
License Number StateVA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: