Healthcare Provider Details

I. General information

NPI: 1730800467
Provider Name (Legal Business Name): SARAH BUNEVICH OTR/L
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 09/09/2022
Last Update Date: 09/09/2022
Certification Date: 09/06/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1958 ELM ST RM 310
DENVER CO
80220-1247
US

IV. Provider business mailing address

1958 ELM ST RM 310
DENVER CO
80220-1247
US

V. Phone/Fax

Practice location:
  • Phone: 303-333-4982
  • Fax:
Mailing address:
  • Phone: 303-333-4982
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225XP0200X
TaxonomyPediatric Occupational Therapist
License Number0006105
License Number StateCO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: