Provider Demographics
NPI:1982293031
Name:SARGENT, SASHA LEIGH (COTA)
Entity type:Individual
Prefix:
First Name:SASHA
Middle Name:LEIGH
Last Name:SARGENT
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 1:8620 WILD DIAMOND AVE
Mailing Address - Street 2:
Mailing Address - City:LAS VEGAS
Mailing Address - State:NV
Mailing Address - Zip Code:89143-5110
Mailing Address - Country:US
Mailing Address - Phone:702-545-5061
Mailing Address - Fax:
Practice Address - Street 1:8620 WILD DIAMOND AVE
Practice Address - Street 2:
Practice Address - City:LAS VEGAS
Practice Address - State:NV
Practice Address - Zip Code:89143-5110
Practice Address - Country:US
Practice Address - Phone:702-545-5061
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-01-13
Last Update Date:2021-01-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NV18-1455224Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes224Z00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapy Assistant