Healthcare Provider Details

I. General information

NPI: 1003489303
Provider Name (Legal Business Name): SARAH MARY EVANKO OTR/L
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/23/2021
Last Update Date: 04/23/2026
Certification Date: 04/23/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3905 UNIVERSITY DR
DURHAM NC
27707-2517
US

IV. Provider business mailing address

3905 UNIVERSITY DR
DURHAM NC
27707-2517
US

V. Phone/Fax

Practice location:
  • Phone: 919-928-0204
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225XP0200X
TaxonomyPediatric Occupational Therapist
License Number14168
License Number StateNC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: