=====================================================
General NPI Number Information
=====================================================
NPI Number | 1053095174
-----------------------------------------------------
Entity Type | Individual
-----------------------------------------------------
Provider Name | SARAH ELIZABETH PAULETT OTR/L, OTD
-----------------------------------------------------
Gender | Female
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 06/09/2023
-----------------------------------------------------
Last Update Date | 06/09/2023
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 975 E 3RD ST
-----------------------------------------------------
City | CHATTANOOGA
-----------------------------------------------------
State | TN
-----------------------------------------------------
Zip | 37403-2173
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 423-778-7916
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 1332 PASSENGER ST APT 307
-----------------------------------------------------
City | CHATTANOOGA
-----------------------------------------------------
State | TN
-----------------------------------------------------
Zip | 37408-1474
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 256-744-5322
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position |
-----------------------------------------------------
Name |
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone |
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 225X00000X
-----------------------------------------------------
Taxonomy Name | Occupational Therapist
-----------------------------------------------------
License Number | 6994
-----------------------------------------------------
License Number State | TN
-----------------------------------------------------