Healthcare Provider Details

I. General information

NPI: 1972489524
Provider Name (Legal Business Name): SARAH DAWSON MCCONNON
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/11/2025
Last Update Date: 10/06/2025
Certification Date: 10/06/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

680 KINGSBOROUGH SQ STE B
CHESAPEAKE VA
23320-4988
US

IV. Provider business mailing address

680 KINGSBOROUGH SQ STE B
CHESAPEAKE VA
23320-4988
US

V. Phone/Fax

Practice location:
  • Phone: 757-547-0434
  • Fax:
Mailing address:
  • Phone: 757-547-0434
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225X00000X
TaxonomyOccupational Therapist
License Number0119011145
License Number StateVA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: