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NPI Code Detail

MEDICARE: SANDRA HART COTA/L

MEDICARE:   SANDRA  HART  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
1224Z00000XOccupational Therapy AssistantMO

General Provider Information

NPI Number : 1154965713
Entity Type Code : Individual
Provider Name (Legal Business Name) : SANDRA HART COTA/L
Provider Business Mailing Address
First Line : 2 HARBOR BEND CT
Second Line :
City : LAKE SAINT LOUIS
State : MO
Zip : 63367-1478
Country : US
Telephone Number : 636-695-2075
Fax Number : 636-695-2080
Provider Business Practice Location Address
First Line : 2 HARBOR BEND CT
Second Line :
City : LAKE SAINT LOUIS
State : MO
Zip : 63367-1478
Country : US
Telephone Number : 636-695-2075
Fax Number : 636-695-2080
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 11/06/2019
Last Update Date : 11/06/2019

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Directions to “ SANDRA HART COTA/L” Practice Location

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