Provider Demographics
NPI:1801005939
Name:GRIFFIN, SONNETTE ANN (COTA/L)
Entity Type:Individual
Prefix:MRS
First Name:SONNETTE
Middle Name:ANN
Last Name:GRIFFIN
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 1:1499 N 159TH AVE APT 2001
Mailing Address - Street 2:
Mailing Address - City:GOODYEAR
Mailing Address - State:AZ
Mailing Address - Zip Code:85395-7198
Mailing Address - Country:US
Mailing Address - Phone:614-571-2010
Mailing Address - Fax:
Practice Address - Street 1:13060 W BELL RD
Practice Address - Street 2:
Practice Address - City:SURPRISE
Practice Address - State:AZ
Practice Address - Zip Code:85378-1200
Practice Address - Country:US
Practice Address - Phone:614-571-2010
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-05-22
Last Update Date:2023-07-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH02932224Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes224Z00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapy Assistant