Provider Demographics
NPI:1932825445
Name:SUMOWSKI, AMY KATHERINE (COTA)
Entity Type:Individual
Prefix:
First Name:AMY
Middle Name:KATHERINE
Last Name:SUMOWSKI
Suffix:
Gender:F
Credentials:COTA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:48 LEYFRED TER
Mailing Address - Street 2:
Mailing Address - City:SPRINGFIELD
Mailing Address - State:MA
Mailing Address - Zip Code:01108-1104
Mailing Address - Country:US
Mailing Address - Phone:413-426-6875
Mailing Address - Fax:
Practice Address - Street 1:305 MAPLE ST STE A
Practice Address - Street 2:
Practice Address - City:EAST LONGMEADOW
Practice Address - State:MA
Practice Address - Zip Code:01028-2776
Practice Address - Country:US
Practice Address - Phone:413-525-6361
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-10-17
Last Update Date:2022-10-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA4832224Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes224Z00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapy Assistant