Provider Demographics
NPI:1467252940
Name:THOMAS, SHERRIANNE (COTA)
Entity type:Individual
Prefix:
First Name:SHERRIANNE
Middle Name:
Last Name:THOMAS
Suffix:
Gender:
Credentials:COTA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:22 DEXTER ST
Mailing Address - Street 2:
Mailing Address - City:HARTFORD
Mailing Address - State:CT
Mailing Address - Zip Code:06106-3938
Mailing Address - Country:US
Mailing Address - Phone:860-841-2556
Mailing Address - Fax:
Practice Address - Street 1:22 DEXTER ST
Practice Address - Street 2:
Practice Address - City:HARTFORD
Practice Address - State:CT
Practice Address - Zip Code:06106-3938
Practice Address - Country:US
Practice Address - Phone:860-841-2556
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-03-14
Last Update Date:2025-03-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT1504224Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes224Z00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapy Assistant