MEDICARE: MRS. SARAH ANNE SMITH OTR/L

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	225X00000X	Occupational Therapist	14050	NC

General Provider Information

NPI Number	:	1770913758
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MRS. SARAH ANNE SMITH OTR/L

Provider Business Mailing Address
First Line	:	313 WOODNETTLE LN
Second Line	:
City	:	ARDEN
State	:	NC
Zip	:	28704-1389
Country	:	US
Telephone Number	:	412-445-9128
Fax Number	:

Provider Business Practice Location Address
First Line	:	4143 HAYWOOD RD
Second Line	:
City	:	MILLS RIVER
State	:	NC
Zip	:	28759-9740
Country	:	US
Telephone Number	:	828-891-2166
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	11/12/2013
Last Update Date	:	07/15/2023

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