Provider Demographics
NPI:1669745931
Name:SHARP, COURTNEY JEAN (COTA/L)
Entity type:Individual
Prefix:
First Name:COURTNEY
Middle Name:JEAN
Last Name:SHARP
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 1:5052 MAID MARION CT
Mailing Address - Street 2:
Mailing Address - City:ASHLAND
Mailing Address - State:KY
Mailing Address - Zip Code:41101-6822
Mailing Address - Country:US
Mailing Address - Phone:160-683-1875
Mailing Address - Fax:
Practice Address - Street 1:901 KILGORE DR
Practice Address - Street 2:
Practice Address - City:ASHLAND
Practice Address - State:KY
Practice Address - Zip Code:41101-3118
Practice Address - Country:US
Practice Address - Phone:606-831-8752
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2012-02-17
Last Update Date:2012-02-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KYKY-A3948224Z00000X, 224ZF0002X, 224ZL0004X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes224Z00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapy Assistant
No224ZF0002XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapy AssistantFeeding, Eating & Swallowing
No224ZL0004XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapy AssistantLow Vision