Healthcare Provider Details

I. General information

NPI: 1902003270
Provider Name (Legal Business Name): SARAH LYNN BROWN COTA
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/29/2007
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3500 E FRANK PHILLIPS BLVD
BARTLESVILLE OK
74006-2411
US

IV. Provider business mailing address

396811 W 2900 RD LOT 37
OCHELATA OK
74051-2467
US

V. Phone/Fax

Practice location:
  • Phone: 918-333-7200
  • Fax:
Mailing address:
  • Phone: 918-535-2449
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code224Z00000X
TaxonomyOccupational Therapy Assistant
License Number882
License Number StateOK

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: