Provider Demographics
NPI:1265669097
Name:WALKER, SHERRON E (COTA/L)
Entity Type:Individual
Prefix:MRS
First Name:SHERRON
Middle Name:E
Last Name:WALKER
Suffix:
Gender:F
Credentials:COTA/L
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:11 WILBUR RD
Mailing Address - Street 2:NEW YORK STATE HVDDSO
Mailing Address - City:THIELLS
Mailing Address - State:NY
Mailing Address - Zip Code:10984-7555
Mailing Address - Country:US
Mailing Address - Phone:845-947-6220
Mailing Address - Fax:
Practice Address - Street 1:11 WILBUR RD
Practice Address - Street 2:NEW YORK STATE HVDDSO
Practice Address - City:THIELLS
Practice Address - State:NY
Practice Address - Zip Code:10984-7555
Practice Address - Country:US
Practice Address - Phone:845-947-6220
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2009-06-19
Last Update Date:2009-06-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY005568-1224Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes224Z00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapy Assistant