Provider Demographics
NPI:1750604724
Name:RIGGINS, SARA (COTA)
Entity type:Individual
Prefix:
First Name:SARA
Middle Name:
Last Name:RIGGINS
Suffix:
Gender:F
Credentials:COTA
Other - Prefix:
Other - First Name:SARA
Other - Middle Name:
Other - Last Name:RIGGINS
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:COTA
Mailing Address - Street 1:1518 GREEN MEADOW RD
Mailing Address - Street 2:
Mailing Address - City:EVANSVILLE
Mailing Address - State:IN
Mailing Address - Zip Code:47715-6058
Mailing Address - Country:US
Mailing Address - Phone:270-860-8599
Mailing Address - Fax:
Practice Address - Street 1:7300 E INDIANA ST
Practice Address - Street 2:
Practice Address - City:EVANSVILLE
Practice Address - State:IN
Practice Address - Zip Code:47715-2794
Practice Address - Country:US
Practice Address - Phone:812-476-0409
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-03-05
Last Update Date:2014-10-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN32001731A224Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes224Z00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapy Assistant