Provider Demographics
NPI:1730643495
Name:SLOAN, JOANNE JACKSON (COTA)
Entity Type:Individual
Prefix:
First Name:JOANNE
Middle Name:JACKSON
Last Name:SLOAN
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 1:9622 REX CREEK CT
Mailing Address - Street 2:
Mailing Address - City:SPRING
Mailing Address - State:TX
Mailing Address - Zip Code:77379-1965
Mailing Address - Country:US
Mailing Address - Phone:713-703-4276
Mailing Address - Fax:
Practice Address - Street 1:9602 HUFFMEISTER RD
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77095-2895
Practice Address - Country:US
Practice Address - Phone:281-463-9001
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-01-28
Last Update Date:2019-01-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX211635224Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes224Z00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapy Assistant