Healthcare Provider Details

I. General information

NPI: 1477464147
Provider Name (Legal Business Name): SARAH E WHITTA COTA/L
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/14/2026
Last Update Date: 09/14/2026
Certification Date: 09/14/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

530 GILMORE ST
KENTON OH
43326-1610
US

IV. Provider business mailing address

530 GILMORE ST
KENTON OH
43326-1610
US

V. Phone/Fax

Practice location:
  • Phone: 937-599-5195
  • Fax:
Mailing address:
  • Phone: 937-599-5195
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code224Z00000X
TaxonomyOccupational Therapy Assistant
License Number008018
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: