Provider Demographics
NPI:1144033101
Name:MALCHEREK, SANDI A (COTA)
Entity type:Individual
Prefix:
First Name:SANDI
Middle Name:A
Last Name:MALCHEREK
Suffix:
Gender:F
Credentials:COTA
Other - Prefix:
Other - First Name:SANDRA
Other - Middle Name:A
Other - Last Name:MALCHEREK
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:COTA
Mailing Address - Street 1:2216 BRIGADOON CT
Mailing Address - Street 2:
Mailing Address - City:ARLINGTON
Mailing Address - State:TX
Mailing Address - Zip Code:76013-5813
Mailing Address - Country:US
Mailing Address - Phone:682-888-8865
Mailing Address - Fax:
Practice Address - Street 1:2216 BRIGADOON CT
Practice Address - Street 2:
Practice Address - City:ARLINGTON
Practice Address - State:TX
Practice Address - Zip Code:76013-5813
Practice Address - Country:US
Practice Address - Phone:682-888-8865
Practice Address - Fax:682-888-8865
Is Sole Proprietor?:Yes
Enumeration Date:2025-01-31
Last Update Date:2025-01-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX218672224Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes224Z00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapy AssistantGroup - Single Specialty