Healthcare Provider Details

I. General information

NPI: 1902201668
Provider Name (Legal Business Name): SARAH YOON OTR
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/23/2014
Last Update Date: 03/03/2025
Certification Date: 02/26/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

OPC 371 BOX 39
APO AP
96271-9001
US

IV. Provider business mailing address

OPC 371 BOX 39
APO AP
96271-9001
US

V. Phone/Fax

Practice location:
  • Phone: 315-737-1411
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code225X00000X
TaxonomyOccupational Therapist
License Number46TR006541
License Number StateNJ
# 2
Primary TaxonomyY
Taxonomy Code225X00000X
TaxonomyOccupational Therapist
License NumberOT008285
License Number StateGA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: