Provider Demographics
NPI:1093116048
Name:COATES, SHARYN ARMSTRONG (MSOTR/L, BCB-PMD)
Entity Type:Individual
Prefix:MRS
First Name:SHARYN
Middle Name:ARMSTRONG
Last Name:COATES
Suffix:
Gender:F
Credentials:MSOTR/L, BCB-PMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2093 HEALTH DR SW STE 201
Mailing Address - Street 2:
Mailing Address - City:WYOMING
Mailing Address - State:MI
Mailing Address - Zip Code:49519-9691
Mailing Address - Country:US
Mailing Address - Phone:616-328-5350
Mailing Address - Fax:616-452-4142
Practice Address - Street 1:2093 HEALTH DR SW STE 201
Practice Address - Street 2:
Practice Address - City:WYOMING
Practice Address - State:MI
Practice Address - Zip Code:49519-9691
Practice Address - Country:US
Practice Address - Phone:616-452-7099
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2014-09-09
Last Update Date:2021-03-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI5201007286225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
MI1134509532Medicaid
MI5201007286OtherLARA MI
MI1588731087Medicaid