Healthcare Provider Details

I. General information

NPI: 1548150782
Provider Name (Legal Business Name): SARAH HENDERSON OTD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: SARAH INGRAM OTD

II. Dates (important events)

Enumeration Date: 07/08/2025
Last Update Date: 07/08/2025
Certification Date: 07/08/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1103 VILLAGE DR
SEVIERVILLE TN
37862-5029
US

IV. Provider business mailing address

1103 VILLAGE DR
SEVIERVILLE TN
37862-5029
US

V. Phone/Fax

Practice location:
  • Phone: 865-908-7041
  • Fax:
Mailing address:
  • Phone: 865-908-3261
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225X00000X
TaxonomyOccupational Therapist
License Number7744
License Number StateTN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: