Healthcare Provider Details

I. General information

NPI: 1285961029
Provider Name (Legal Business Name): SARAH E. YEATON OTR/L
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 11/16/2009
Last Update Date: 11/16/2009
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

484 MAIN ST
WORCESTER MA
01608-1893
US

IV. Provider business mailing address

484 MAIN ST
WORCESTER MA
01608-1893
US

V. Phone/Fax

Practice location:
  • Phone: 800-244-2756
  • Fax: 508-831-9768
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225X00000X
TaxonomyOccupational Therapist
License Number9965
License Number StateMA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: