Provider Demographics
NPI:1457814717
Name:ANNE, CHERYL (COTA)
Entity Type:Individual
Prefix:
First Name:CHERYL
Middle Name:
Last Name:ANNE
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 1:2544 HAULOVER BLVD
Mailing Address - Street 2:
Mailing Address - City:DELTONA
Mailing Address - State:FL
Mailing Address - Zip Code:32738-1506
Mailing Address - Country:US
Mailing Address - Phone:386-281-2494
Mailing Address - Fax:
Practice Address - Street 1:830 29TH ST
Practice Address - Street 2:
Practice Address - City:ORLANDO
Practice Address - State:FL
Practice Address - Zip Code:32805-6219
Practice Address - Country:US
Practice Address - Phone:407-843-3230
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-04-12
Last Update Date:2019-04-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes224Z00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapy Assistant