Healthcare Provider Details

I. General information

NPI: 1649535097
Provider Name (Legal Business Name): SARAH BOLLINGER MOT, OTR/L
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/11/2012
Last Update Date: 06/28/2025
Certification Date: 06/28/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2713 BREEZEWOOD AVE
FAYETTEVILLE NC
28303-5534
US

IV. Provider business mailing address

2713 BREEZEWOOD AVE
FAYETTEVILLE NC
28303-5534
US

V. Phone/Fax

Practice location:
  • Phone: 910-488-4100
  • Fax:
Mailing address:
  • Phone: 910-488-4100
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code225X00000X
TaxonomyOccupational Therapist
License Number117710
License Number StateTX
# 2
Primary TaxonomyN
Taxonomy Code225X00000X
TaxonomyOccupational Therapist
License Number12242
License Number StateFL
# 3
Primary TaxonomyY
Taxonomy Code225XP0200X
TaxonomyPediatric Occupational Therapist
License Number10159
License Number StateNC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: