Healthcare Provider Details

I. General information

NPI: 1831093384
Provider Name (Legal Business Name): SYDNEY ELLEN MCCORT COTA/L
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 10/07/2026
Last Update Date: 10/07/2026
Certification Date: 10/07/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

518 S 8TH ST
CAMBRIDGE OH
43725-2767
US

IV. Provider business mailing address

518 S 8TH ST
CAMBRIDGE OH
43725-2767
US

V. Phone/Fax

Practice location:
  • Phone: 740-584-7930
  • Fax:
Mailing address:
  • Phone: 740-584-7930
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code224Z00000X
TaxonomyOccupational Therapy Assistant
License NumberOTA008460
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: