Provider Demographics
NPI:1881414472
Name:THOMPSON, SABRINA AMBER (COTA/L)
Entity type:Individual
Prefix:
First Name:SABRINA
Middle Name:AMBER
Last Name:THOMPSON
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 1:295 SOUTHVIEW LN
Mailing Address - Street 2:
Mailing Address - City:BLAND
Mailing Address - State:VA
Mailing Address - Zip Code:24315-1500
Mailing Address - Country:US
Mailing Address - Phone:304-923-8695
Mailing Address - Fax:
Practice Address - Street 1:PO BOX 299
Practice Address - Street 2:
Practice Address - City:BECKLEY
Practice Address - State:WV
Practice Address - Zip Code:25802-0299
Practice Address - Country:US
Practice Address - Phone:304-222-1421
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-10-16
Last Update Date:2024-10-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VAC1794224Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes224Z00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapy Assistant