Healthcare Provider Details

I. General information

NPI: 1689221673
Provider Name (Legal Business Name): SARAH BETH GALL OTR/L
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 08/23/2019
Last Update Date: 08/23/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3053 NEW GERMANY RD
EBENSBURG PA
15931-3516
US

IV. Provider business mailing address

3837 GRAHAM AVE
WINDBER PA
15963-4508
US

V. Phone/Fax

Practice location:
  • Phone: 814-472-1100
  • Fax: 814-472-6445
Mailing address:
  • Phone: 814-322-7179
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225X00000X
TaxonomyOccupational Therapist
License NumberOC008987
License Number StatePA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: