Provider Demographics
NPI:1811656580
Name:SCARBROUGH, SARAH RENEE (COTA/L)
Entity type:Individual
Prefix:
First Name:SARAH
Middle Name:RENEE
Last Name:SCARBROUGH
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 1:4900 SW 46TH CT APT 2002
Mailing Address - Street 2:
Mailing Address - City:OCALA
Mailing Address - State:FL
Mailing Address - Zip Code:34474-6286
Mailing Address - Country:US
Mailing Address - Phone:229-869-4113
Mailing Address - Fax:
Practice Address - Street 1:3270 SE 58TH AVE
Practice Address - Street 2:STE C, BLDG 2
Practice Address - City:OCALA
Practice Address - State:FL
Practice Address - Zip Code:34480
Practice Address - Country:US
Practice Address - Phone:229-869-4113
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-12-10
Last Update Date:2021-12-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLOTA17109224Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes224Z00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapy Assistant