Provider Demographics
NPI:1326342213
Name:EATON, CHERYL A (COTA/L)
Entity Type:Individual
Prefix:
First Name:CHERYL
Middle Name:A
Last Name:EATON
Suffix:
Gender:F
Credentials:COTA/L
Other - Prefix:MS
Other - First Name:SHERRY
Other - Middle Name:A
Other - Last Name:EATON
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:COTA/L
Mailing Address - Street 1:1513 N 2ND ST
Mailing Address - Street 2:
Mailing Address - City:MEMPHIS
Mailing Address - State:TN
Mailing Address - Zip Code:38107-1003
Mailing Address - Country:US
Mailing Address - Phone:901-272-2494
Mailing Address - Fax:901-272-6976
Practice Address - Street 1:5086 SEA ISLE RD
Practice Address - Street 2:
Practice Address - City:MEMPHIS
Practice Address - State:TN
Practice Address - Zip Code:38117-6336
Practice Address - Country:US
Practice Address - Phone:901-827-3227
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-01-06
Last Update Date:2011-01-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN1450224Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes224Z00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapy Assistant