Provider Demographics
NPI:1104318245
Name:SHERRED, ELIZABETH MAY (COTA)
Entity type:Individual
Prefix:
First Name:ELIZABETH
Middle Name:MAY
Last Name:SHERRED
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:PO BOX 8969
Mailing Address - Street 2:
Mailing Address - City:MILESBURG
Mailing Address - State:PA
Mailing Address - Zip Code:16853-8969
Mailing Address - Country:US
Mailing Address - Phone:877-312-6576
Mailing Address - Fax:
Practice Address - Street 1:560 E 3RD ST
Practice Address - Street 2:
Practice Address - City:ERIE
Practice Address - State:PA
Practice Address - Zip Code:16507-1753
Practice Address - Country:US
Practice Address - Phone:814-964-0545
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-06-05
Last Update Date:2018-06-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAOP007466225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist