Healthcare Provider Details

I. General information

NPI: 1700701968
Provider Name (Legal Business Name): SANDRA J COOK COTA
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 08/13/2026
Last Update Date: 08/13/2026
Certification Date: 08/13/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2000 RESERVE BLVD
SPRING HILL TN
37174-2370
US

IV. Provider business mailing address

142 EWINGVILLE DR # B
FRANKLIN TN
37064-3218
US

V. Phone/Fax

Practice location:
  • Phone: 931-486-4200
  • Fax:
Mailing address:
  • Phone: 972-415-8989
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code224Z00000X
TaxonomyOccupational Therapy Assistant
License Number4173
License Number StateTN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: