Provider Demographics
NPI:1124161401
Name:QUIRK, SARAH MELISSA (COTA)
Entity type:Individual
Prefix:MRS
First Name:SARAH
Middle Name:MELISSA
Last Name:QUIRK
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 1:2028 EDMONDSON AVE
Mailing Address - Street 2:
Mailing Address - City:CATONSVILLE
Mailing Address - State:MD
Mailing Address - Zip Code:21228-4235
Mailing Address - Country:US
Mailing Address - Phone:410-746-3913
Mailing Address - Fax:410-744-3603
Practice Address - Street 1:2028 EDMONDSON AVE
Practice Address - Street 2:
Practice Address - City:CATONSVILLE
Practice Address - State:MD
Practice Address - Zip Code:21228-4235
Practice Address - Country:US
Practice Address - Phone:410-746-3913
Practice Address - Fax:410-744-3603
Is Sole Proprietor?:No
Enumeration Date:2007-02-15
Last Update Date:2014-06-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDA00657224Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes224Z00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapy Assistant