Provider Demographics
NPI:1568998854
Name:POWERS, SARA MARIE (COTA/L)
Entity Type:Individual
Prefix:
First Name:SARA
Middle Name:MARIE
Last Name:POWERS
Suffix:
Gender:F
Credentials:COTA/L
Other - Prefix:
Other - First Name:SARA
Other - Middle Name:MARIE
Other - Last Name:NELSON
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:COTA/L
Mailing Address - Street 1:8540 SCARBOROUGH DR
Mailing Address - Street 2:#200
Mailing Address - City:COLORADO SPRINGS
Mailing Address - State:CO
Mailing Address - Zip Code:80920-7502
Mailing Address - Country:US
Mailing Address - Phone:253-508-2118
Mailing Address - Fax:719-630-8099
Practice Address - Street 1:8540 SCARBOROUGH DR
Practice Address - Street 2:#200
Practice Address - City:COLORADO SPRINGS
Practice Address - State:CO
Practice Address - Zip Code:80920-7502
Practice Address - Country:US
Practice Address - Phone:253-508-2118
Practice Address - Fax:719-630-8099
Is Sole Proprietor?:No
Enumeration Date:2017-05-04
Last Update Date:2017-05-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
COOTA.0000903224Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes224Z00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapy Assistant