Healthcare Provider Details

I. General information

NPI: 1306452297
Provider Name (Legal Business Name): SARAH ELIZABETH GORRELL OT
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 09/16/2020
Last Update Date: 07/16/2024
Certification Date: 07/16/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

901 SOMERBY DR
MOBILE AL
36695-3490
US

IV. Provider business mailing address

8910 PURDUE RD STE 700
INDIANAPOLIS IN
46268-6136
US

V. Phone/Fax

Practice location:
  • Phone: 228-357-5671
  • Fax:
Mailing address:
  • Phone: 800-603-6046
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code106S00000X
TaxonomyBehavior Technician
License NumberRBT-20-134865
License Number StateMS
# 2
Primary TaxonomyY
Taxonomy Code225X00000X
TaxonomyOccupational Therapist
License Number6350
License Number StateAL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: