Provider Demographics
NPI:1962597245
Name:COTA, SARAH AUDIGIER (QMHA)
Entity type:Individual
Prefix:MRS
First Name:SARAH
Middle Name:AUDIGIER
Last Name:COTA
Suffix:
Gender:F
Credentials:QMHA
Other - Prefix:MS
Other - First Name:SARAH
Other - Middle Name:AUDIGIER
Other - Last Name:PERKINS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:1293 NW WALL ST
Mailing Address - Street 2:#1382
Mailing Address - City:BEND
Mailing Address - State:OR
Mailing Address - Zip Code:97701-1936
Mailing Address - Country:US
Mailing Address - Phone:541-385-6436
Mailing Address - Fax:
Practice Address - Street 1:60949 SNOWBRUSH DR
Practice Address - Street 2:
Practice Address - City:BEND
Practice Address - State:OR
Practice Address - Zip Code:97702
Practice Address - Country:US
Practice Address - Phone:541-385-6436
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-04
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FAMILY SKILLS COACH174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist
Provider Identifiers
StateIdentifier IDID TypeIssuer
ORR46228OtherDHS STATE OF OR