Provider Demographics
NPI:1780193342
Name:MILBRATH, SABINA NICOLE (COTA)
Entity Type:Individual
Prefix:
First Name:SABINA
Middle Name:NICOLE
Last Name:MILBRATH
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 1:3288 E 2ND AVE
Mailing Address - Street 2:
Mailing Address - City:POST FALLS
Mailing Address - State:ID
Mailing Address - Zip Code:83854-9634
Mailing Address - Country:US
Mailing Address - Phone:208-964-2656
Mailing Address - Fax:
Practice Address - Street 1:1801 E UPRIVER DR
Practice Address - Street 2:
Practice Address - City:SPOKANE
Practice Address - State:WA
Practice Address - Zip Code:99207-5181
Practice Address - Country:US
Practice Address - Phone:509-483-6483
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2017-09-27
Last Update Date:2018-06-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WA60751042224Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes224Z00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapy Assistant