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General NPI Number Information
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NPI Number | 1457833840
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Entity Type | Individual
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Provider Name | SARAH MEAD COTA/L
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Gender | Female
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Dates
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Enumeration Date | 08/31/2018
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Last Update Date | 01/23/2024
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Provider Practice Location Address
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Address Line | 618 W NORTH ST
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City | MOUNTAIN GROVE
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State | MO
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Zip | 65711-1931
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Country | US
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Telephone | 623-707-3729
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Fax |
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Provider Business Mailing Address
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Address Line | 618 W NORTH ST
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City | MOUNTAIN GROVE
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State | MO
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Zip | 65711-1931
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Country | US
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Telephone | 623-707-3729
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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 | 6148
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License Number State | AZ
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Taxonomy #2
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Taxonomy Code | 225X00000X
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Taxonomy Name | Occupational Therapist
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License Number | 6148
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License Number State | AZ
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Taxonomy #3
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Taxonomy Code | 224Z00000X
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Taxonomy Name | Occupational Therapy Assistant
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License Number | 2020017503
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License Number State | MO
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