Provider Demographics
NPI:1972850709
Name:MOTTE, SANDRA JOY (COTA)
Entity Type:Individual
Prefix:
First Name:SANDRA
Middle Name:JOY
Last Name:MOTTE
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 1:275 WOODGROVE DR
Mailing Address - Street 2:
Mailing Address - City:ATHENS
Mailing Address - State:GA
Mailing Address - Zip Code:30605-7510
Mailing Address - Country:US
Mailing Address - Phone:706-201-4577
Mailing Address - Fax:
Practice Address - Street 1:275 WOODGROVE DR
Practice Address - Street 2:
Practice Address - City:ATHENS
Practice Address - State:GA
Practice Address - Zip Code:30605
Practice Address - Country:US
Practice Address - Phone:706-201-4577
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2012-08-10
Last Update Date:2012-08-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC8369224Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes224Z00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapy Assistant