Healthcare Provider Details

I. General information

NPI: 1619908506
Provider Name (Legal Business Name): SARAH C OKOON ATR-BC, C-PAT
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/06/2006
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2327 LIME KILN LN
LOUISVILLE KY
40222-3422
US

IV. Provider business mailing address

6725 ELMCROFT CIR
LOUISVILLE KY
40241-5846
US

V. Phone/Fax

Practice location:
  • Phone: 502-339-2818
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101Y00000X
TaxonomyCounselor
License NumberKY-0119
License Number StateKY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: