Provider Demographics
NPI:1932305158
Name:STEVENSON, SANDRA (COTA)
Entity Type:Individual
Prefix:
First Name:SANDRA
Middle Name:
Last Name:STEVENSON
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 1:3507 JAIME ZAPATA MEMORIAL HWY
Mailing Address - Street 2:SUITE 7
Mailing Address - City:LAREDO
Mailing Address - State:TX
Mailing Address - Zip Code:78043-4769
Mailing Address - Country:US
Mailing Address - Phone:956-753-5600
Mailing Address - Fax:
Practice Address - Street 1:3507 JAIME ZAPATA MEMORIAL HWY
Practice Address - Street 2:SUITE 7
Practice Address - City:LAREDO
Practice Address - State:TX
Practice Address - Zip Code:78043-4769
Practice Address - Country:US
Practice Address - Phone:956-753-5600
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-06-25
Last Update Date:2013-07-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC5489224Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes224Z00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapy Assistant