Healthcare Provider Details

I. General information

NPI: 1437963600
Provider Name (Legal Business Name): SONJA HOFFMAN COTA/L
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 02/06/2025
Last Update Date: 02/06/2025
Certification Date: 02/06/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

22725 HIGHWAY 76 E
CLINTON SC
29325-7527
US

IV. Provider business mailing address

22725 HIGHWAY 76 E
CLINTON SC
29325-7527
US

V. Phone/Fax

Practice location:
  • Phone: 864-358-7415
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code224Z00000X
TaxonomyOccupational Therapy Assistant
License Number3268
License Number StateSC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: