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General NPI Number Information
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NPI Number | 1083815211
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Entity Type | Individual
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Provider Name | SARAH L. YODER B.S.,COTA
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Gender | Female
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Dates
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Enumeration Date | 05/28/2007
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Last Update Date | 07/08/2007
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Provider Practice Location Address
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Address Line | 100 W STATE ST
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City | BOISE
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State | ID
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Zip | 83702-6126
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Country | US
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Telephone | 208-489-4640
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Fax |
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Provider Business Mailing Address
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Address Line | 2655 E RED CEDAR LN N201
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City | BOISE
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State | ID
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Zip | 83716-9687
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Country | US
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Telephone | 208-571-5098
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 224Z00000X
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Taxonomy Name | Occupational Therapy Assistant
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License Number | 201
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License Number State | ID
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Taxonomy #2
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Taxonomy Code | 224Z00000X
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Taxonomy Name | Occupational Therapy Assistant
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License Number | 3253
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License Number State | OH
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