Healthcare Provider Details

I. General information

NPI: 1669336392
Provider Name (Legal Business Name): SARAH LOFTUS OT
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 12/16/2025
Last Update Date: 12/16/2025
Certification Date: 12/16/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8382 N WAYNE DR STE 204
HAYDEN ID
83835-6028
US

IV. Provider business mailing address

5752 N LA ROCHELLE DR
COEUR D ALENE ID
83815-9147
US

V. Phone/Fax

Practice location:
  • Phone: 208-719-9071
  • Fax:
Mailing address:
  • Phone: 308-216-0151
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225X00000X
TaxonomyOccupational Therapist
License Number2871182
License Number StateID

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: