Provider Demographics
NPI:1326543174
Name:SANDERS, MONICA (COTA)
Entity Type:Individual
Prefix:
First Name:MONICA
Middle Name:
Last Name:SANDERS
Suffix:
Gender:F
Credentials:COTA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:744 COUNTY ROAD 1111
Mailing Address - Street 2:
Mailing Address - City:MAUD
Mailing Address - State:TX
Mailing Address - Zip Code:75567-2594
Mailing Address - Country:US
Mailing Address - Phone:903-949-0775
Mailing Address - Fax:
Practice Address - Street 1:744 COUNTY ROAD 1111
Practice Address - Street 2:
Practice Address - City:MAUD
Practice Address - State:TX
Practice Address - Zip Code:75567-2594
Practice Address - Country:US
Practice Address - Phone:903-949-0775
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-03-26
Last Update Date:2018-03-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX213781224Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes224Z00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapy Assistant