Provider Demographics
NPI:1063997815
Name:FORSTHOFF, SARAH JOY (COTA/L)
Entity type:Individual
Prefix:MRS
First Name:SARAH
Middle Name:JOY
Last Name:FORSTHOFF
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 1:102 PASSAGE DR
Mailing Address - Street 2:
Mailing Address - City:LAFAYETTE
Mailing Address - State:LA
Mailing Address - Zip Code:70506-6641
Mailing Address - Country:US
Mailing Address - Phone:337-534-6546
Mailing Address - Fax:
Practice Address - Street 1:101 COTTAGE CREEK CIR
Practice Address - Street 2:
Practice Address - City:GREER
Practice Address - State:SC
Practice Address - Zip Code:29650-2438
Practice Address - Country:US
Practice Address - Phone:337-534-6546
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-09-27
Last Update Date:2018-09-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLOTA10148224Z00000X
LAOTA.200439224Z00000X
MSTA3007224Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes224Z00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapy Assistant