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General NPI Number Information
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NPI Number | 1194290379
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Entity Type | Individual
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Provider Name | SARAH LYNN CHARBONEAU COTA/L
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Gender | Female
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Dates
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Enumeration Date | 10/03/2018
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Last Update Date | 10/03/2018
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Provider Practice Location Address
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Address Line | 8301 E PRENTICE AVE STE 207
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City | GREENWOOD VILLAGE
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State | CO
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Zip | 80111-2905
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Country | US
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Telephone | 719-632-8325
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Fax |
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Provider Business Mailing Address
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Address Line | 2346 PARK CENTER DR APT 8405
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City | WESTMINSTER
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State | CO
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Zip | 80234-5636
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Country | US
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Telephone | 701-331-4388
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 224Z00000X
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Taxonomy Name | Occupational Therapy Assistant
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License Number | OTA.0001112
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License Number State | CO
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