Basic Information
| Provider Information | |||||||||
| NPI: | 1750584041 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | SEXTON | ||||||||
| FirstName: | STEPHEN | ||||||||
| MiddleName: | MICHAEL | ||||||||
| NamePrefix: | MR. | ||||||||
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| Credential: | COTA | ||||||||
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| Mailing Information | |||||||||
| Address1: | 77 FIR HILL DRIVE | ||||||||
| Address2: | APT. 7C10 | ||||||||
| City: | AKRON | ||||||||
| State: | OH | ||||||||
| PostalCode: | 44304 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 3304124863 | ||||||||
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| Practice Location | |||||||||
| Address1: | 155 HERITAGE WOODS DR | ||||||||
| Address2: | |||||||||
| City: | COPLEY | ||||||||
| State: | OH | ||||||||
| PostalCode: | 443211398 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 3306660980 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 06/06/2007 | ||||||||
| LastUpdateDate: | 07/08/2007 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 224Z00000X | OTA 3558 | OH | Y | Respiratory, Developmental, Rehabilitative and Restorative Service Providers | Occupational Therapy Assistant |
No ID Information.