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General NPI Number Information
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NPI Number | 1538737523
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Entity Type | Individual
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Provider Name | SARAH MARIE SORENSEN COTA/L
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Gender | Female
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Dates
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Enumeration Date | 06/15/2021
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Last Update Date | 07/25/2023
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Provider Practice Location Address
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Address Line | 4725 W ALMOND AVE
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City | COOLIDGE
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State | AZ
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Zip | 85128-7210
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Country | US
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Telephone | 623-565-4535
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Fax |
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Provider Business Mailing Address
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Address Line | 23624 N 38TH DR
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City | GLENDALE
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State | AZ
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Zip | 85310-4110
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Country | US
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Telephone |
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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-046949
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License Number State | AZ
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