Provider Demographics
NPI:1518202290
Name:COTCAMP, SARAH LYNN (LICENSED MASSAGE THE)
Entity Type:Individual
Prefix:
First Name:SARAH
Middle Name:LYNN
Last Name:COTCAMP
Suffix:
Gender:F
Credentials:LICENSED MASSAGE THE
Other - Prefix:
Other - First Name:SARAH
Other - Middle Name:LYNN
Other - Last Name:ROE
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:LMT
Mailing Address - Street 1:4 ALLEN DR.
Mailing Address - Street 2:
Mailing Address - City:WHITNEY POINT
Mailing Address - State:NY
Mailing Address - Zip Code:13862
Mailing Address - Country:US
Mailing Address - Phone:607-321-5334
Mailing Address - Fax:
Practice Address - Street 1:2586 MAIN ST.
Practice Address - Street 2:
Practice Address - City:WHITNEY POINT
Practice Address - State:NY
Practice Address - Zip Code:13862
Practice Address - Country:US
Practice Address - Phone:607-321-5334
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-12-06
Last Update Date:2024-01-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY025265225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist