Provider Demographics
NPI:1548404676
Name:CAMERON, SHERI LEE (COTA)
Entity Type:Individual
Prefix:MRS
First Name:SHERI
Middle Name:LEE
Last Name:CAMERON
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 1:26260 HOFFMEYER ST
Mailing Address - Street 2:
Mailing Address - City:ROSEVILLE
Mailing Address - State:MI
Mailing Address - Zip Code:48066-4965
Mailing Address - Country:US
Mailing Address - Phone:586-201-5363
Mailing Address - Fax:
Practice Address - Street 1:1101 ROCK ST
Practice Address - Street 2:
Practice Address - City:BOWIE
Practice Address - State:TX
Practice Address - Zip Code:76230-3115
Practice Address - Country:US
Practice Address - Phone:586-201-5363
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2009-04-20
Last Update Date:2009-04-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI5202004416225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist