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NPI Code Detail

MEDICARE: MISS SARAH MICHELLE VIVIANO COTA/L

MEDICARE: MISS SARAH MICHELLE VIVIANO 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 Assistant5202008608MI

General Provider Information

NPI Number : 1801489414
Entity Type Code : Individual
Provider Name (Legal Business Name) : MISS SARAH MICHELLE VIVIANO COTA/L
Provider Business Mailing Address
First Line : 13711 MIDDLEBURY
Second Line :
City : SHELBY TOWNSHIP
State : MI
Zip : 48315-2830
Country : US
Telephone Number : 586-719-3465
Fax Number :
Provider Business Practice Location Address
First Line : 21450 ARCHWOOD CIR
Second Line :
City : FARMINGTON HILLS
State : MI
Zip : 48336-4127
Country : US
Telephone Number : 248-477-7400
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 02/15/2021
Last Update Date : 02/15/2021

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