Healthcare Provider Details

I. General information

NPI: 1467933549
Provider Name (Legal Business Name): SHARON YEE COTA
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/27/2018
Last Update Date: 08/27/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

60 WOOD ST
PAINESVILLE OH
44077-3396
US

IV. Provider business mailing address

8070 DEEPWOOD BLVD APT F7
MENTOR OH
44060-7770
US

V. Phone/Fax

Practice location:
  • Phone: 440-338-8220
  • Fax:
Mailing address:
  • Phone: 216-440-2116
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code224Z00000X
TaxonomyOccupational Therapy Assistant
License NumberOTA007365
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: