MEDICARE: MRS. SHARON LOUISE HOGAN COTA/L

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	224Z00000X	Occupational Therapy Assistant	OA1740	ME

General Provider Information

NPI Number	:	1104093384
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MRS. SHARON LOUISE HOGAN COTA/L

Provider Business Mailing Address
First Line	:	46 BRYANT RD
Second Line	:
City	:	SAINT ALBANS
State	:	ME
Zip	:	04971-7326
Country	:	US
Telephone Number	:	207-938-2546
Fax Number	:	207-938-2546

Provider Business Practice Location Address
First Line	:	46 BRYANT RD
Second Line	:
City	:	SAINT ALBANS
State	:	ME
Zip	:	04971-7326
Country	:	US
Telephone Number	:	207-938-2546
Fax Number	:	207-938-2546

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	05/15/2008
Last Update Date	:	05/15/2008

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