Provider Demographics
NPI:1518549633
Name:SCARCELLA, SARAH J (COTA/L)
Entity Type:Individual
Prefix:MISS
First Name:SARAH
Middle Name:J
Last Name:SCARCELLA
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 1:806 W MINNESOTA AVE
Mailing Address - Street 2:
Mailing Address - City:DELAND
Mailing Address - State:FL
Mailing Address - Zip Code:32720-3203
Mailing Address - Country:US
Mailing Address - Phone:716-698-4534
Mailing Address - Fax:
Practice Address - Street 1:806 W MINNESOTA AVE
Practice Address - Street 2:
Practice Address - City:DELAND
Practice Address - State:FL
Practice Address - Zip Code:32720-3203
Practice Address - Country:US
Practice Address - Phone:716-698-4534
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-04-27
Last Update Date:2021-04-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL15966224Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes224Z00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapy Assistant