Provider Demographics
NPI:1942783378
Name:PITTMAN, SHERIAN DENISE (COTA)
Entity Type:Individual
Prefix:
First Name:SHERIAN
Middle Name:DENISE
Last Name:PITTMAN
Suffix:
Gender:F
Credentials:COTA
Other - Prefix:
Other - First Name:SHERIAN
Other - Middle Name:DENISE
Other - Last Name:MATTHEWS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:COTA
Mailing Address - Street 1:7129 FORT COLLINS DR
Mailing Address - Street 2:
Mailing Address - City:CORPUS CHRISTI
Mailing Address - State:TX
Mailing Address - Zip Code:78413-4351
Mailing Address - Country:US
Mailing Address - Phone:361-816-3026
Mailing Address - Fax:
Practice Address - Street 1:5607 EVERHART RD
Practice Address - Street 2:
Practice Address - City:CORPUS CHRISTI
Practice Address - State:TX
Practice Address - Zip Code:78411-4904
Practice Address - Country:US
Practice Address - Phone:361-854-4601
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-09-11
Last Update Date:2018-09-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX206650224Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes224Z00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapy Assistant