Provider Demographics
NPI:1053718809
Name:GERARD, SYLVIA (COTA/L)
Entity type:Individual
Prefix:
First Name:SYLVIA
Middle Name:
Last Name:GERARD
Suffix:
Gender:F
Credentials:COTA/L
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:511 CEDAR AVE
Mailing Address - Street 2:
Mailing Address - City:TILLAMOOK
Mailing Address - State:OR
Mailing Address - Zip Code:97141-3528
Mailing Address - Country:US
Mailing Address - Phone:330-412-3559
Mailing Address - Fax:
Practice Address - Street 1:511 CEDAR AVE
Practice Address - Street 2:
Practice Address - City:TILLAMOOK
Practice Address - State:OR
Practice Address - Zip Code:97141-3528
Practice Address - Country:US
Practice Address - Phone:330-412-3559
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2014-11-21
Last Update Date:2014-11-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OR285174224Z00000X
OH04654224Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes224Z00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapy Assistant