Provider Demographics
NPI:1184918146
Name:SEXTON, CATHLEEN MARY (COTA/L)
Entity type:Individual
Prefix:MS
First Name:CATHLEEN
Middle Name:MARY
Last Name:SEXTON
Suffix:
Gender:F
Credentials:COTA/L
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
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Other - Credentials:
Mailing Address - Street 1:18 IRIS AVE
Mailing Address - Street 2:APT 3
Mailing Address - City:FLORAL PARK
Mailing Address - State:NY
Mailing Address - Zip Code:11001-2735
Mailing Address - Country:US
Mailing Address - Phone:516-326-7644
Mailing Address - Fax:
Practice Address - Street 1:8009 WINCHESTER BLVD
Practice Address - Street 2:
Practice Address - City:QUEENS VILLAGE
Practice Address - State:NY
Practice Address - Zip Code:11427-2147
Practice Address - Country:US
Practice Address - Phone:516-459-0128
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2011-06-07
Last Update Date:2011-06-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY006282-1224Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes224Z00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapy Assistant